Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards

John P Handrakis, Michelle Trbovich, Ellen Merete Hagen, Michael Price

Research output: Contribution to journalArticle

Abstract

Introduction: The ability to maintain core body temperature (Tcore) within a narrow range (37 ± 0.6 °C), despite exposure to a wide range of ambient temperatures, is essential in order to provide an optimal environment for vital organs, the central nervous system (CNS), and cellular processes to function. High-level (above T6) spinal cord injury (SCI) interrupts the autonomic nervous system's ability to carry out hypothalamic regulation of thermoregulatory mechanisms for both heat dissipation and conservation. This interruption leaves persons with high-level SCI vulnerable to hyper and hypothermia even during exposure to relatively mild ambient temperatures. The goal of the Autonomic Standards is to enable the clinician to quickly identify those individuals with SCI who may be most at risk for thermoregulatory dysfunction.

Case presentation: Case 1: Heat Exhaustion, Case 2: Heat Stroke in absence of CNS symptoms, Case 3: Heat Exhaustion.

Discussion: The three cases demonstrate the signs and symptoms that may accompany hyperthermia in persons with SCI. The onset may be quite rapid and the condition persistent, despite ambient temperatures being much less intense than expected to be necessary to induce similar conditions in able-bodied (AB) persons. The responses of the persons in the case studies to the temperature regulation and autonomic control of sweating sections of the Autonomic Standards would identify them as being vulnerable and warrant providing appropriate exposure guidelines and precautions to them and their caregivers.

Original languageEnglish
Pages (from-to)17086
JournalSpinal cord series and cases
Volume3
DOIs
Publication statusPublished - 6 Dec 2017

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Spinal Cord Injuries
Heat Exhaustion
Temperature
Central Nervous System
Heat Stroke
Sweating
Autonomic Nervous System
Hypothermia
Body Temperature
Caregivers
Signs and Symptoms
Fever
Hot Temperature
Guidelines

Keywords

  • Journal Article

Cite this

Thermodysregulation in persons with spinal cord injury : case series on use of the autonomic standards. / Handrakis, John P; Trbovich, Michelle; Hagen, Ellen Merete; Price, Michael.

In: Spinal cord series and cases, Vol. 3, 06.12.2017, p. 17086.

Research output: Contribution to journalArticle

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AB - Introduction: The ability to maintain core body temperature (Tcore) within a narrow range (37 ± 0.6 °C), despite exposure to a wide range of ambient temperatures, is essential in order to provide an optimal environment for vital organs, the central nervous system (CNS), and cellular processes to function. High-level (above T6) spinal cord injury (SCI) interrupts the autonomic nervous system's ability to carry out hypothalamic regulation of thermoregulatory mechanisms for both heat dissipation and conservation. This interruption leaves persons with high-level SCI vulnerable to hyper and hypothermia even during exposure to relatively mild ambient temperatures. The goal of the Autonomic Standards is to enable the clinician to quickly identify those individuals with SCI who may be most at risk for thermoregulatory dysfunction.Case presentation: Case 1: Heat Exhaustion, Case 2: Heat Stroke in absence of CNS symptoms, Case 3: Heat Exhaustion.Discussion: The three cases demonstrate the signs and symptoms that may accompany hyperthermia in persons with SCI. The onset may be quite rapid and the condition persistent, despite ambient temperatures being much less intense than expected to be necessary to induce similar conditions in able-bodied (AB) persons. The responses of the persons in the case studies to the temperature regulation and autonomic control of sweating sections of the Autonomic Standards would identify them as being vulnerable and warrant providing appropriate exposure guidelines and precautions to them and their caregivers.

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