TY - JOUR
T1 - An epidural cooling catheter protects the spinal cord against ischemic injury in pigs
AU - Mori, Atsuo
AU - Ueda, Toshihiko
AU - Hachiya, Takashi
AU - Kabei, Nobuyuki
AU - Okano, Hideyuki
AU - Yozu, Ryohei
AU - Sasaki, Tatsuumi
N1 - Funding Information:
We express special thanks to Shigeyuki Takeuchi, MD, Hideyuki Shimizu, MD, Akihiro Yoshitake, MD, Katsuhisa Onoguchi, MD, Hiromitsu Takakura, MD, Michio Yoshitake, MD, Shingo Taguchi, MD, Yasunori Cho, MD, Shinya Inoue, MD, Tashiro Ryoichi, PhD, Shinobu Negishi, Takashi Kimura, Kazunori Yoshinaga, Shinji Matsuo, Kumi Takeda, Atsushi Saito, Ryota Wada, Norio Koike, Tatsuya Takagi, Fumie Oyama, Akemi Misawa, and Takeshi Yokomura for their technical assistance. This work was financially supported by the scientific research fund of Saitama prefecture.
PY - 2005/11
Y1 - 2005/11
N2 - Background. Using swine, we investigated whether epidural placement of a cooling catheter rather than infusing iced saline solution could protect the spinal cord from ischemia during aortic surgery. Methods. We divided 14 domestic pigs into two groups of 7 each. Each underwent epidural catheter placement preceding 30 minutes of aortic cross-clamping distal to the origin of the left subclavian artery. In group 1, cold water was circulated continuously through the lumen of the catheter connected to an external unit. In group 2, animals received catheter placement without cooling. Spinal cord somatosensory evoked potentials were recorded. Neurologic status involving hind limbs was graded sequentially after surgery. Results. At aortic cross-clamping, spinal temperature in group 1 (31.7° ± 0.6°C) was significantly lower than in group 2 (37.8° ± 0.4°C; p < 0.0001). No significant elevation of intrathecal pressure accompanied cooling with the catheter (group 1, 8.1 ± 1.7 mm Hg; group 2, 8.0 ± 1.5 mm Hg). Mean duration of total loss of potentials was significantly shorter in group 1 (7.4 ± 3.8 minutes) than group 2 (19.7 ± 7.3 minutes; p = 0.0002). Pigs in group 1 exhibited better hind limb function recovery (mean Tarlov score, 4.7 ± 0.5) than group 2 (0.6 ± 0.8; p = 0.0017). Group 1 showed normal histologic characteristics, whereas group 2 showed loss of motor neurons in the ventral horns. Conclusions. Epidural cooling catheter without iced saline infusion can cool the spinal cord without elevating intrathecal pressure, protecting the cord against ischemia.
AB - Background. Using swine, we investigated whether epidural placement of a cooling catheter rather than infusing iced saline solution could protect the spinal cord from ischemia during aortic surgery. Methods. We divided 14 domestic pigs into two groups of 7 each. Each underwent epidural catheter placement preceding 30 minutes of aortic cross-clamping distal to the origin of the left subclavian artery. In group 1, cold water was circulated continuously through the lumen of the catheter connected to an external unit. In group 2, animals received catheter placement without cooling. Spinal cord somatosensory evoked potentials were recorded. Neurologic status involving hind limbs was graded sequentially after surgery. Results. At aortic cross-clamping, spinal temperature in group 1 (31.7° ± 0.6°C) was significantly lower than in group 2 (37.8° ± 0.4°C; p < 0.0001). No significant elevation of intrathecal pressure accompanied cooling with the catheter (group 1, 8.1 ± 1.7 mm Hg; group 2, 8.0 ± 1.5 mm Hg). Mean duration of total loss of potentials was significantly shorter in group 1 (7.4 ± 3.8 minutes) than group 2 (19.7 ± 7.3 minutes; p = 0.0002). Pigs in group 1 exhibited better hind limb function recovery (mean Tarlov score, 4.7 ± 0.5) than group 2 (0.6 ± 0.8; p = 0.0017). Group 1 showed normal histologic characteristics, whereas group 2 showed loss of motor neurons in the ventral horns. Conclusions. Epidural cooling catheter without iced saline infusion can cool the spinal cord without elevating intrathecal pressure, protecting the cord against ischemia.
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U2 - 10.1016/j.athoracsur.2005.04.031
DO - 10.1016/j.athoracsur.2005.04.031
M3 - Article
C2 - 16242463
AN - SCOPUS:26844448229
SN - 0003-4975
VL - 80
SP - 1829
EP - 1833
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -