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Ischemic preconditioning and spinal cord function monitoring in the descending thoracic aorta approach.

Abstract：

OBJECTIVES:To evaluate the effectiveness of acute ischemic preconditioning (IP), based on somatosensory evoked potentials (SSEP) monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. METHODS:Twenty-eight dogs were submitted to spinal cord ischemic injury attained by descending thoracic aorta cross-clamping. In the C45 group, the aortic cross-clamping time was 45 min (n=7); in the IP45 group, the dogs were submitted to IP before the aortic cross-clamping for 45 min (n=7). In the C60 group, the dogs were submitted to 60 min of aortic cross-clamping (n=7), as in the IP60 group that was previously submitted to IP. The IP cycles were determined based on SSEP changes. RESULTS:Tarlov scores of the IP groups were significantly better than those of the controls (p = 0.005). Paraplegia was observed in 3 dogs from C45 and in 6 from C60 group, although all dogs from IP45 group were neurologically normal, as 4 dogs from IP60. There was a significant correlation between SSEP recovery time until one hour of aortic reperfusion and the neurological status (p = 0.011), showing sensitivity of 75% and specificity of 83%. CONCLUSION:Repetitive acute IP based on SSEP is a protection factor during spinal cord ischemia, decreasing paraplegia incidence. SSEP monitoring seems to be a good neurological injury assessment method during surgical procedures that involve spinal cord ischemia.

journal_name

Arq Bras Cardiol

journal_title

Arquivos brasileiros de cardiologia

authors

Mônaco BA,Benício A,Contreras IS,Mingrone LE,Ballester G,Moreira LF

doi

10.1590/s0066-782x2007000300007

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

291-6

issue

3

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2007000300007

journal_volume

88

pub_type

杂志文章

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