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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2001 Aprile;42(2):227-31

lingua: Inglese

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


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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.

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