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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES VASCULAR PAPERS
The Journal of Cardiovascular Surgery 2001 April;42(2):227-31
Influence of low proximal aortic pressure on spinal cord oxygenation in experimental thoracic aortic occlusion
Hellberg A., Tulga Ulus A., Christiansson L. *, Bergqvist D., Thelin S. **, Karacagil S.
From the Departments of Surgery *Anaesthesiology and **Thoracic Surgery University Hospital, Uppsala, Sweden
Background. To evaluate the effect of low proximal aortic pressure on cerebrospinal fluid (CSF) oxygenation in an experimental thoracic occlusion model.
Methods. In nine pigs, continuous intrathecal pO2, pCO2 and pH monitoring was used during double descending thoracic aortic clamping following insertion of an aorto-aortic shunt. In five pigs, the shunt was connected to a citrated bag adjusted at approximately 40-45 cm above the heart for partial exsanguination in order to decrease mean proximal aortic pressure (MPAP) to below 50 mmHg. In four animals, sodium nitroprusside infusion was used for this purpose.
Results. Intrathecal pO2 demonstrated a significant decrease from 4.9±2.1 to 2.9±2.4 kPa after 10 minutes of aortic cross-clamping. Lowering proximal aortic pressure caused a further significant decrease to 1.2±1.7 kPa (p<0.05). In seven pigs (5 in the exsanguination and 2 in the vasodilator group), restoration of mean proximal aortic pressure to 94.0±27.7 caused a recovery of CSF pO2 from 1.2±1.9 to 2.8±3.0 (p<0.05).
Conclusions. The results of this study demonstrate that MPAP which provides spinal cord perfusion through subclavian-vertebral arteries are crucial for maintenance of spinal cord oxygenation during thoracic aortic occlusion in this pig model.