HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Moreira, L. F. P. Search for Related Content PubMed Articles by Moreira, L. F. P. Related Collections Cerebral protection Great vessels

Eur J Cardiothorac Surg 2006;29:127
© 2006 Elsevier Science NL

Letter to the Editor

Reply to Toumpoulis

Cardiothoracic Surgery Division, 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

Received 19 October 2005; accepted 21 October 2005.

^_* Tel.: +55 11 30695075; fax: +55 11 30695318. (Email: dcimoreira{at}incor.usp.br).

Key Words: Spinal cord • Aortic cross-clamping • Ischemic preconditioning • Evoked potentials

We appreciate the comments of Ioannis K. Toumpoulis about our paper concerning the use of immediate ischemic preconditioning based on somatosensory evoked potentials to prevent spinal cord injury [1]. In that study, it was shown that ischemic tolerance could be immediately achieved in the spinal cord against a clinically relevant ischemic insult, since ischemic preconditioning was based on the proper selection of induction times and intervals in dogs. This observation was obtained without significant differences between the groups with regard to proximal and distal aortic pressures at baseline, during the aortic cross-clamping and at the reperfusion period, as mentioned. During the aortic cross-clamping period, low doses of sodium nitroprusside were used to reduce the arterial blood pressure, explaining the described results. Nevertheless, no important hypotension was observed during the reperfusion interval in all the experiments of the three groups and it was not possible to detect any correlation between neurologic or histopathologic outcome with differences in arterial pressure during reperfusion or aortic cross-clamping time intervals.

We agree with Toumpoulis and coworkers [2,3] that hypotension episodes during the reperfusion period may influence the neurologic outcome in these experimental models of spinal cord ischemia after aortic cross-clamping. However, this finding does not appear to have influenced our data.

References

1. Contreras IS, Moreira LF, Ballester G, de Monaco BA, Lancellotti CL, Dias AR, Oliveira SA. Immediate ischemic preconditioning based on somatosensory evoked potentials seems to prevent spinal cord injury following descending thoracic aorta cross-clamping. Eur J Cardiothorac Surg 2005;28:274-279.[Abstract/Free Full Text]
2. Toumpoulis IK, Anagnostopoulos CE, Drossos GE, Malamou-Mitsi VD, Pappa LS, Katritsis DG. Early ischemic preconditioning without hypotension prevents spinal cord injury caused by descending thoracic aortic occlusion. J Thorac Cardiovasc Surg 2003;125:1030-1036.[Abstract/Free Full Text]
3. Toumpoulis IK, Papakostas JC, Matsagas MI, Malamou-Mitsi VD, Pappa LS, Drossos GE, DeRose JJ, Anagnostopoulos CE. Superiority of early relative to late ischemic preconditioning in spinal cord protection after descending thoracic aortic occlusion. J Thorac Cardiovasc Surg 2004;128:724-730.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Moreira, L. F. P. Search for Related Content PubMed Articles by Moreira, L. F. P. Related Collections Cerebral protection Great vessels