Hypothermic regional perfusion for protection of the spinal cord during periods of ischemia. 1987

R Colon, and O H Frazier, and D A Cooley, and H A McAllister

Ischemic spinal cord injury with resulting postoperative paraplegia is an inherent risk for operations on the thoracic aorta. The mechanism of injury is not clearly understood, and numerous adjuncts to avoid this complication have been suggested, with conflicting clinical results. A new technique of hypothermic regional perfusion of the spinal cord is described. Fifteen female pigs weighing 21 to 39 kg were used for the experiment. The control group consisted of 5 animals in which the thoracic aorta was clamped at the distal arch for 30 minutes. All of these animals sustained postoperative neurological damage. Eighty percent sustained postoperative paraplegia, and 20% had severe spasticity of the hind legs that precluded normal ambulation. The experimental group consisted of 10 animals in which hypothermic regional perfusion was performed for 30 minutes after cross-clamping of the distal arch. Perfusion cooling was followed by 30 minutes of ischemia in 5 animals and 45 minutes of ischemia in the remaining 5. All animals that underwent hypothermic regional perfusion were able to walk postoperatively, and no evidence of ischemic injury was found at postmortem examination of the spinal cords. This technique proved to be simple and effective in protecting the spinal cord for up to 45 minutes of ischemia in the experimental group. The clinical implications of this concept are promising for patients undergoing operations on the thoracic aorta.

UI MeSH Term Description Entries
D007036 Hypothermia, Induced Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries. Induced Hypothermia,Mild Hypothermia, Induced,Moderate Hypothermia, Induced,Targeted Temperature Management,Therapeutic Hypothermia,Hypothermia, Therapeutic,Induced Mild Hypothermia,Induced Mild Hypothermias,Induced Moderate Hypothermia,Induced Moderate Hypothermias,Mild Hypothermias, Induced,Moderate Hypothermias, Induced,Targeted Temperature Managements
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D007511 Ischemia A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION. Ischemias
D010264 Paraplegia Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness. Paralysis, Lower Extremities,Paraplegia, Spastic,Spastic Paraplegia,Paralysis, Legs,Paralysis, Lower Limbs,Paraplegia, Ataxic,Paraplegia, Cerebral,Paraplegia, Flaccid,Paraplegia, Spinal,Ataxic Paraplegia,Ataxic Paraplegias,Cerebral Paraplegia,Cerebral Paraplegias,Flaccid Paraplegia,Flaccid Paraplegias,Paraplegias,Paraplegias, Ataxic,Paraplegias, Cerebral,Paraplegias, Flaccid,Paraplegias, Spastic,Paraplegias, Spinal,Spastic Paraplegias,Spinal Paraplegia,Spinal Paraplegias
D010477 Perfusion Treatment process involving the injection of fluid into an organ or tissue. Perfusions
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D003250 Constriction The act of constricting. Clamping,Clampings,Constrictions
D005260 Female Females
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001013 Aorta, Thoracic The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA. Aorta, Ascending,Aorta, Descending,Aortic Arch,Aortic Root,Arch of the Aorta,Descending Aorta,Sinotubular Junction,Ascending Aorta,Thoracic Aorta,Aortic Roots,Arch, Aortic,Ascending Aortas,Junction, Sinotubular,Root, Aortic,Sinotubular Junctions

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