Document Detail


Augmentation of systemic blood pressure during spinal cord ischemia to prevent postoperative paraplegia after aortic surgery in a rabbit model.
MedLine Citation:
PMID:  19910005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
So Izumi; Kenji Okada; Tomomi Hasegawa; Atsushi Omura; Hiroshi Munakata; Masamichi Matsumori; Yutaka Okita
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Publication Detail:
Type:  Journal Article     Date:  2009-11-11
Journal Detail:
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:
Created Date:  2010-04-23     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1261-8     Citation Subset:  AIM; IM    
Copyright Information:
2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
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MeSH Terms
Descriptor/Qualifier:
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:
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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