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Eur J Cardiothorac Surg 2005;28:274-279
© 2005 Elsevier Science NL
Original articles |
a Cardiothoracic Surgery, Heart Institute (Incor) Division, University of São Paulo Medical School, São Paulo, SP, Brazil
b Experimental and Functional Neurosurgery Laboratory, University of São Paulo Medical School, São Paulo, SP, Brazil
c Department of Pathology, Santa Casa School of Medicine, São Paulo, SP, Brazil
Received 1 December 2004; received in revised form 3 March 2005; accepted 9 March 2005.
* Corresponding author. Address: Division of Surgery, Heart Institute (Incor), University of São Paulo Medical School, Av. Dr. Enéas Carvalho Aguiar, 44, 2 Level, Block 2, Room 13, 05403-000 São Paulo, SP, Brazil. Tel.: +55 11 30695075; fax: +55 11 30695318. (Email: dcimoreira{at}incor.usp.br).
Abstract
Objective: Delayed ischemic preconditioning has demonstrated neuroprotective effects in spinal cord ischemia. We investigated the effects of immediate ischemic preconditioning based on somatosensory evoked potentials monitoring in a model of spinal cord injury due descending thoracic aorta occlusion in dogs. Methods: Twenty-one dogs were submitted to spinal cord ischemia induced by descending thoracic aorta cross-clamping for 45min. Control group underwent only the aortic cross-clamping (n=7), group A underwent one cycle of ischemic preconditioning (n=7) and group B underwent three equal cycles of ischemic preconditioning (n=7), immediately before the aortic cross-clamping. Ischemic preconditioning cycles were determined by somatosensory evoked potentials monitoring. Neurologic evaluation was performed according to the Tarlov score at 72h of follow-up. The animals were then sacrificed and the spinal cord harvested for histopathology. Results: Aortic pressures before and after the occluded segment were similar in the three groups. Ischemic preconditioning periods corresponded to a mean ischemic time of 3±1min and a mean recovery time of 7±2min. Severe paraplegia was observed in three animals in Control group, in four in group A and in none in group B. Tarlov scores of group B were significantly better in comparison to the Control group (P=0.036). Histopathologic examination showed severe neuronal necrosis in the thoracic and lumbar gray matter in animals who presented paraplegia. Conclusions: Immediate repetitive ischemic preconditioning based on somatosensory evoked potentials monitoring seems to protect spinal cord during descending aorta cross-clamping, reducing paraplegia incidence.
Key Words: Aortic aneurysm • Spinal cord • Paraplegia • Ischemic preconditioning • Evoked potential
This article has been cited by other articles:
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  H. Huang, L. Zhang, Y. Wang, J. Yao, H. Weng, H. Wu, Z. Chen, and J. Liu Effect of ischemic post-conditioning on spinal cord ischemic-reperfusion injury in rabbits: [Effet du post-conditionnement ischemique sur les lesions d'ischemie-reperfusion de la moelle epiniere chez le lapin] Can J Anesth, January 1, 2007; 54(1): 42 - 48. [Abstract] [Full Text] [PDF]
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 I. K. Toumpoulis Immediate ischemic preconditioning for spinal cord protection following descending thoracic aortic cross-clamping Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 126 - 126. [Full Text] [PDF]
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L. F. P. Moreira Reply to Toumpoulis Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 127 - 127. [Full Text] [PDF]
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