276
CHAPTER 25
CERVIC. 6
in
ro
-\
ABC
CERVIC. 7
THORAC. 3
THORAC. 8
ABC
ABC ABC
NORMAL (I)
If)
UJ
z
O
I u
UJ
I-
<
U
NORMAL (2) NORMAL (3)
n
A: SUPINE
B: SITTING
C: STANDING
Ad B
NAd
FIG. 121. Shows the adrenaline and noradrenaline values in the peripheral plasma of
normal and paraplegic subjects with different levels of lesion (A) supine, (B) seated
and (C) standing or held vertically for
2
min. Adrenaline values are shown • and
noradrenaline D-
The plasma catecholamine changes in patients who fainted after tilting to the vertical
showed a marked degree of inconsistency. It was found that the increase of adrenaline
was much greater than noradrenaline in the plasma, and the total catecholamine values
were increased.
It is obvious that these disturbances of vasomotor control to change of posture from
the horizontal position in cord lesions above T5 can be more easily elicited the more
recent the cord transection. This was found by Silver (1971) in the acute stages of tetra-
plegia during tilt-up experiments ranging from 15° to 45° with maximum duration of
350 sec, by measuring blood pressure and heart rate.
Reconditioning of postural hypotension
Attention was paid to means of overcoming the postural circulatory disturbances in these
high spinal cord lesions. It was found that regular and frequent change of posture from
the supine to the lateral position in the early stages following transection represents in
itself an important stimulus in setting up vasoconstrictor responses in the isolated cord
to restore the crippled vasomotor control.
