脊髓损伤血流控制的闭环方案：超声监测驱动去甲肾上腺素输注
Closing the loop on blood flow control in spinal cord injury
研究设计了一种闭环控制器，依据超声测得的脊髓血流量调节药物输注，在动物中稳定损伤部位灌注并保留神经功能。该方案针对脊髓损伤后仅靠升压保护组织、不直接监测脊髓血流的问题，采用去甲肾上腺素进行闭环反馈控制。
- Research Briefing
- Published: 29 October 2026
Nature Biomedical Engineering (2026) Cite this article
After spinal cord injury, clinicians raise blood pressure to protect tissue without directly monitoring the effect on the cord, exposing patients to harm. We designed a closed-loop controller that adjusts drug infusion in response to ultrasonography-based measurements of spinal cord blood flow, stabilizing perfusion at the injury site and preserving neurological function in animals.
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References
Routkevitch, D. et al. Spinal cord vascular autoregulation: key concepts and opportunities to improve management. Spinal Cord 64, 14–28 (2026). This article reviews the relationship between blood pressure and spinal cord blood flow, with a focus on clinical importance.
Gallagher, M. J. et al. Spinal cord blood flow in patients with acute spinal cord injuries. J. Neurotrauma 36, 919–929 (2019). This paper showed that spinal cord blood flow can be measured in patients and that it deviates from systemic blood pressure.
Squair, J. W. et al. Spinal cord perfusion pressure predicts neurologic recovery in acute spinal cord injury. Neurology 89, 1660–1667 (2017). This article illustrated the imprecision of pressure-based management and its impact on patient outcomes.
Khaing, Z. Z. et al. Perfusion imaging metrics after acute traumatic spinal cord injury are associated with injury severity in rats and humans. Sci. Transl. Med. 16, eadn4970 (2024). This study showed that ultrasonography-derived perfusion metrics after spinal cord injury predict injury severity.
Chesnut, R. et al. A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Intensive Care Med. 46, 919–929 (2020). This study is an example of the clinical use of end-organ physiology guiding treatment in patients with traumatic brain injury.
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This is a summary of: Routkevitch, D. et al. Optimal closed-loop feedback control of blood flow after spinal cord injury with norepinephrine. Nat. Biomed. Eng. https://doi.org/10.1038/s41551-026-01777-6 (2026).
D.R., N.V.T. and N.T. used Claude AI to help prepare their contribution to this Research Briefing.
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Cite this article
Closing the loop on blood flow control in spinal cord injury. Nat. Biomed. Eng (2026). https://doi.org/10.1038/s41551-026-01784-7
Published: 29 October 2026
Version of record: 29 October 2026
DOI: https://doi.org/10.1038/s41551-026-01784-7
来源：Nature Biotechnology · nature.com