Document Detail


Spinal oxygenation, blood supply localization, cooling, and function with aortic clamping.
MedLine Citation:
PMID:  1610258     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Similar to other methods of organ preservation, "spinoplegia" may protect the spinal cord from the effects of oxygen desaturation during aortic cross-clamping. In porcine experiments, spinal cord O2 saturation was studied during intraoperative localization of the blood supply to the spinal cord using hydrogen; division of arteries not supplying the spinal cord; aortic cross-clamping for 60 minutes; and 60 minutes after unclamping. In 5 animals, 120 mL of cold saline solution with lidocaine (100 mg/dL) was infused into the aorta during aortic cross-clamping. During sequential localization, O2 saturation dropped by 40.02% (standard deviation, 20.16%) for T-14 artery testing versus a decrease of 17.27% (standard deviation, 11.88%; p = 0.0075) for L-5 artery segment testing in the control animals and returned to baseline thereafter. During aortic cross-clamping maximal O2 desaturation was 5% of baseline (15.7%; p less than 0.0001), which improved slightly by 30 minutes after clamping (48% of baseline +/- 37.37%; p = 0.048 versus maximum) and then returned to baseline (97.1% of baseline +/- 41%) with unclamping; 5 minutes later, hyperoxygenation occurred with a progressive decline thereafter (68% of baseline +/- 29.3%; p = 0.025, 45 minutes after unclamping versus baseline). The decrease in spinal motor evoked potentials was significantly less (p less than 0.02) in the treated group. Intraoperative hydrogen testing in 8 patients was demonstrated to be safe. It accurately localized reattached arteries, and O2 saturation of the spinal cord fell by 56% (standard deviation, 29%; p = 0.0025) with aortic cross-clamping. We conclude that spinal cord ischemia occurs with aortic cross-clamping in both animals and humans.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
L G Svensson; E S Crawford; V Patel; T R McLean; J W Jones; M E DeBakey
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  54     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-07-21     Completed Date:  1992-07-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  74-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Baylor College of Medicine, Houston, Texas 77030.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aorta, Abdominal / surgery*
Aorta, Thoracic / surgery*
Constriction
Humans
Ischemia / metabolism*
Lidocaine / therapeutic use*
Male
Oxygen Consumption*
Postoperative Complications / prevention & control*
Spinal Cord / blood supply*,  drug effects,  metabolism*
Swine
Chemical
Reg. No./Substance:
137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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