Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) < 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents. Our survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI.

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影响多发伤患者的脊髓损伤急性期管理：ASAP 研究

很少有关于多发伤患者急性期创伤性脊髓损伤 (tSCI) 管理的数据。由于最初几个小时的治疗选择可能对 tSCI 患者的结果产生深远影响，我们进行了一项国际调查来调查这个主题。该调查由29个项目组成。调查的主要终点是检查：（1）血流动力学和呼吸管理，（2）凝血管理，（3）磁共振成像（MRI）和脊柱手术的时间，（4）皮质类固醇治疗的使用, (5) 脊髓内压 (ISP)/脊髓灌注压 (SCPP) 监测的作用和 (6) 低温治疗的利用。来自全球 139 个中心的 171 名受访者。几乎一半的病例选择了 80-90 mmHg 的目标平均动脉压 (MAP) [n = 84 (49.1%)]。大多数受访者都接受了在多发伤中实现出血控制所必需的时间内暂时降低目标 MAP [n = 100 (58.5%)]。61 名受访者 (35.7%) 认为 tSCI 多发性创伤患者的血红蛋白 (Hb) 水平为 7 g/dl 是可以接受的。选择了 80-100 mmHg [n = 94 (55%)] 的动脉氧分压 (PaO2) 和 35-40 mmHg [n = 130 (76%)] 的动脉二氧化碳分压 (PaCO2)在大多数情况下。略多于一半的受访者认为血小板 (PLT) 计数 > 100.000/mm3 [n = 99 (57.9%)] 和凝血酶原时间 (PT)/活化部分促凝血酶原激酶时间 (aPTT) < 正常对照的 1.5 倍 [n = 85 (49. 7%)] 在需要脊柱手术的患者中。大多数受访者应在颅内、血流动力学和呼吸稳定后进行 MRI [n = 160 (93.6%)] 和脊柱手术 [n = 158 (92.4%)]。大多数受访者未使用皮质类固醇 [n = 103 (60.2%)]、ISP/SCPP 监测 [n = 148 (86.5%)] 和低温治疗 [n = 137 (80%)]。我们的调查表明，多发伤 tSCI 患者急性期管理的临床实践在全球范围内存在很大差异。这些发现有助于定义未来的研究，以优化对 tSCI 患者的护理。大多数受访者没有使用低温治疗 [n = 137 (80%)]。我们的调查表明，多发伤 tSCI 患者急性期管理的临床实践在全球范围内存在很大差异。这些发现有助于定义未来的研究，以优化对 tSCI 患者的护理。大多数受访者没有使用低温治疗 [n = 137 (80%)]。我们的调查表明，多发伤 tSCI 患者急性期管理的临床实践在全球范围内存在很大差异。这些发现有助于定义未来的研究，以优化对 tSCI 患者的护理。