Metabolic and endocrine changes in spinal cord injury: II (section 1). Consequences of partial decentralization of the autonomic nervous system.

The article is section 1 of the second part of a 4-part series which provides a comprehensive, concise review of pertinent literature published in the last 25 years on the metabolic and endocrine consequences of spinal cord injury (SCI). This article describes the consequences of total removal of the sympathetic and partial removal of the parasympathetic nervous system from brain integration. Subjects reviewed include bradycardia, altered coagulation, blood pressure instability, relation of hypotension to level of injury, blood and urine neurohormones, hemodynamic responses to stress and fluid infusions, neural components of glucose regulation, evaluation of catecholamines and their metabolites at different time periods, and evaluation of catecholamies, blood dopamine hydroxylase, and prostaglandins during hypotension and hypertension. Other studies reviewed include investigations of metabolic and circulatory responses to exogenous norepinephrine and physiologic and biochemical responses to intense cold and to sodium depletion. Data are organized under the following heads: a. Problems Studied, b. Methods of Investigation and Results, and c. Conclusions. Pertinent highlights from the original articles are organized in tables, to facilitate direct comparisons between similar studies and between data on healthy subjects and SCI patients. Additional studies dealing wth partial decentralization of the autonomic nervous system will be reviewed in section 2 of Part II of this series.