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Spinal cord injury during selective cerebral perfusion and segmental artery occlusion: an experimental study

Mustonen Caius; Kiviluoma Kai; Honkanen Hannu-Pekka; Anttila Vesa; Tuominen Hannu; Juvonen Tatu

dc.contributor.authorMustonen Caius
dc.contributor.authorKiviluoma Kai
dc.contributor.authorHonkanen Hannu-Pekka
dc.contributor.authorAnttila Vesa
dc.contributor.authorTuominen Hannu
dc.contributor.authorJuvonen Tatu
dc.date.accessioned2022-10-28T12:40:36Z
dc.date.available2022-10-28T12:40:36Z
dc.identifier.urihttps://www.utupub.fi/handle/10024/161244
dc.description.abstract<p>OBJECTIVES<br>Since selective cerebral perfusion (SCP) has been used in aortic arch surgical procedures, the core temperature during lower body circulatory arrest (LBCA) has been steadily rising. Simultaneously, the use of a frozen elephant trunk (FET) graft has been increasing. The safe period of LBCA in relation to spinal cord ischaemic tolerance in combination with segmental artery occlusion by the FET procedure has not been defined.<br>METHODS<br>Sixteen pigs were assigned to undergo 65 (n = 10) or 90 min (n = 6) of SCP at 28°C with LBCA in combination with occlusion of the 8 uppermost segmental arteries in the thoracic (Th) aorta (15–20 cm FET, Th8-level). The follow-up period consisted of a 6-h intensive period and a 5-day observation period. Near-infrared spectroscopy of the collateral network was used to determine spinal cord oxygenation. The neurological status of the patients was evaluated daily, and the brain and the spinal cord were harvested for a histopathological analysis.<br>RESULTS<br>Five out of 6 pigs after 90 min and 1 out of 10 pigs after 65 min of LBCA died within 48 h of multiorgan failure. Of the survivors in the 65-min group, 6 out of 9 had paraparesis/paraplegia; the remaining 3 reached normal function. The lone survivor after 90 min of LBCA was paraplegic. Nadir near-infrared spectroscopy of the collateral network values at Th8 and Th10 were 34 (±5) and 39 (±4), and they were reached within 35 min of SCP in both groups.<br>CONCLUSIONS<br>An extended FET graft with LBCA and SCP durations >65 min at 28°C results in a poor outcome.<br></p>
dc.language.isoen
dc.publisherEuropean Association for Cardio-thoracic Surgery
dc.titleSpinal cord injury during selective cerebral perfusion and segmental artery occlusion: an experimental study
dc.identifier.urnURN:NBN:fi-fe2022081154175
dc.relation.volume34
dc.contributor.organizationfi=kirurgia|en=Surgery|
dc.contributor.organizationfi=tyks, vsshp|en=tyks, vsshp|
dc.contributor.organization-code2607309
dc.converis.publication-id69184881
dc.converis.urlhttps://research.utu.fi/converis/portal/Publication/69184881
dc.format.pagerange145
dc.format.pagerange152
dc.identifier.eissn1569-9285
dc.identifier.jour-issn1569-9293
dc.okm.affiliatedauthorDataimport, tyks, vsshp
dc.okm.affiliatedauthorAnttila, Vesa
dc.okm.discipline3126 Kirurgia, anestesiologia, tehohoito, radiologiafi_FI
dc.okm.discipline3126 Surgery, anesthesiology, intensive care, radiologyen_GB
dc.okm.internationalcopublicationnot an international co-publication
dc.okm.internationalityInternational publication
dc.okm.typeJournal article
dc.publisher.countryUnited Kingdomen_GB
dc.publisher.countryBritanniafi_FI
dc.publisher.country-codeGB
dc.relation.doi10.1093/icvts/ivab219
dc.relation.ispartofjournalInteractive Cardiovascular and Thoracic Surgery
dc.relation.issue1
dc.year.issued2022


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