| Augmentation of systemic blood pressure during spinal cord ischemia to prevent postoperative paraplegia after aortic surgery in a rabbit model. | |
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MedLine Citation:
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PMID: 19910005 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Paraplegia from spinal cord ischemia remains an unresolved complication in thoracoabdominal aortic surgery, with high morbidity and mortality. This study investigated postoperative effects of systemic blood pressure augmentation during ischemia. METHODS: Spinal cord ischemia was induced in rabbits by infrarenal aortic occlusion for 15 minutes with infused phenylephrine (high blood pressure group, n = 8) or nitroprusside (low blood pressure group, n = 8) or without vasoactive agent (control, n = 8). Spinal cord blood flow, transcranial motor evoked potentials, neurologic outcome, and motor neuron cell damage (apoptosis, necrosis, superoxide generation, myeloperoxidase activity) were evaluated. RESULTS: Mean arterial pressures during ischemia were controlled at 121.9 +/- 2.8, 50.8 +/- 4.3, and 82.3 +/- 10.7 mm Hg in high blood pressure, low blood pressure, and control groups, respectively. In high blood pressure group, high spinal cord blood flow (P < .01), fast recovery of transcranial motor evoked potentials (P < .01), and high neurologic score (P < .05) were observed after ischemia relative to low blood pressure and control groups. At 48 hours after ischemia, there were significantly more viable neurons, fewer terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling-positive neurons, and less alpha-fodrin expression in high blood pressure group than low blood pressure and control groups. Superoxide generation and myeloperoxidase activity at 3 hours after ischemia were suppressed in high blood pressure group relative to low blood pressure group. CONCLUSIONS: Augmentation of systemic blood pressure during spinal cord ischemia can reduce ischemic insult and postoperative neurologic adverse events. |
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Authors:
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So Izumi; Kenji Okada; Tomomi Hasegawa; Atsushi Omura; Hiroshi Munakata; Masamichi Matsumori; Yutaka Okita |
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Publication Detail:
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Type: Journal Article Date: 2009-11-11 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 139 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-23 Completed Date: 2010-05-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1261-8 Citation Subset: AIM; IM |
Copyright Information:
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2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Aorta / physiopathology* Apoptosis Balloon Dilatation / adverse effects* Blood Pressure / drug effects* Carrier Proteins / metabolism Disease Models, Animal Electric Stimulation Evoked Potentials, Motor Infusions, Intravenous Microfilament Proteins / metabolism Motor Neurons / drug effects, metabolism, pathology Necrosis Neurologic Examination Nitroprusside / administration & dosage Oxidative Stress / drug effects Paraplegia / etiology, pathology, physiopathology, prevention & control* Peroxidase / metabolism Phenylephrine / administration & dosage* Rabbits Regional Blood Flow / drug effects Spinal Cord / blood supply, drug effects*, metabolism, pathology Spinal Cord Ischemia / drug therapy*, etiology, pathology, physiopathology Superoxides / metabolism Time Factors Vasoconstrictor Agents / administration & dosage* Vasodilator Agents / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/Carrier Proteins; 0/Microfilament Proteins; 0/Vasoconstrictor Agents; 0/Vasodilator Agents; 0/fodrin; 11062-77-4/Superoxides; 15078-28-1/Nitroprusside; 59-42-7/Phenylephrine; EC 1.11.1.7/Peroxidase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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