Anaesthesia of the spinal cord-injured patient: cardiovascular problems and their management

An increased venous capacity and a decreased myocardial contractility can be expected in patients with an acute spinal cord lesion at or above T6. Both factors may contribute to a high incidence of arterial hypotension and pulmonary oedema in these patients especially during anaesthesia. We feel that the Swan-Ganz catheter provides valuable information concerning prevention, diagnosis and treatment of arterial hypotension and pulmonary oedema. Although there may be occasional difficulty in interpretation of measurements from the Swan-Ganz catheter if high airway pressures are used, it is a more sensitive monitor than C.V.P. measurement and is particularly useful in patients with a sympathectomy secondary to spinal cord trauma.