Randomized Trial of Early Hemodynamic Management of Patients Following Acute Spinal Cord Injury

In this study, the investigators will learn about the effect of targeted blood pressure
management (TPM) on participants healing from acute spinal cord injury.

The investigators want to learn:

The effect of two types of TPM on long term motor and sensory outcomes. The effect of two
types of TPM on long-term pain and functional independence outcomes.

How safe TPM is for participants.

Inclusion Criteria:

1. Acute traumatic SCI involving neurological levels as defined by the ASIA neurological
examination between C0 and T8 (tetraplegia) and resulting in new onset neurological
deficits consistent with an ASIA motor assessment of level A, B or C.

2. Subject is 18 years of age or older.

Exclusion Criteria:

1. Penetrating SCI injury.

2. Isolated cauda equina syndrome or injury at bony level Th9 or below.

3. Central cord syndrome, as determined by the primary admitting team.

4. History of demyelinating disease or central nervous system autoimmune disorder.

5. History within the past six months and/or physical findings on admission of
decompensated congestive heart failure (NYHA functional class III or IV, or objective
class C or D).

6. Acute, evolving or recent (30 days) myocardial infarction.

7. Chronic renal failure requiring dialysis.

8. Suspected or confirmed pregnancy.

9. Severe terminal disease with life expectancy less than 6 months.

10. Severe traumatic brain injury at presentation (GCS ≤8) with confirmation of injury on
brain imaging.

11. A condition that would preclude the performance of an accurate neurological exam due
to a prior diagnosis of Alzheimer's disease, stroke, degenerative condition, cerebral
tumor, or mental retardation.

12. Non-English or Non-Spanish Speaking.

13. Refusal of consent.