Less invasive perfusion techniques may improve outcome in thoracoabdominal aortic surgery

The impact of deep and moderate body temperatures on end-organ function during hypothermic circulatory arrest

“…To avoid ischaemia-related complications and potential side effects of deep temperatures, additional lower body perfusion during HCA may improve clinical results, as previously shown for abdominal aortic surgery as well as thoraco-abdominal aortic repair [23][24][25]. Furthermore, previous special antibiotic treatment to avoid peritonitis and bacteraemias may have an additional benefit.…”

Ischemic preconditioning ameliorates spinal cord ischemia-reperfusion injury by triggering autoregulation

“…4,22 Several protective strategies have been developed that attempt to preserve blood supply or increase spinal cord ischemic tolerance. 1,3,4 However, no method can completely prevent the development of paraplegia. Spinal cord I/R injuries leading to hypoperfusion and resulting in oxygen deficiency have been demonstrated.…”

“…1 Spinal cord ischemia-reperfusion (I/R) injury can be reduced by lesser ischemic duration, newer centrifugal pump distal perfusion techniques, localized hypothermia, cerebrospinal fluid (CSF) drainage, motor-evoked or somatosensory-evoked potential monitoring, increased mean arterial pressure, reconstruction of the artery of Adamkiewicz, and the use of various neuroprotective pharmacologic agents [2][3][4] ; however, their therapeutic effects are controversial and limited. Pathogenic mechanisms of neuronal cell death after spinal cord I/R injury include excitotoxicity, apoptosis, mitochondrial dysfunction, free radical damage, nitric oxide production, inflammation, and postischemic spinal cord hypoperfusion.…”

Protective effect of delta opioid agonist [d-Ala2, d-Leu5] enkephalin on spinal cord ischemia reperfusion injury by regional perfusion into abdominal aorta in rabbits

“…3A-C). The median values of the number of surviving neurons (interquartile ranges) were 0 (0-0) in the control group, 3 (1)(2)(3)(4)(5) in the DADLE group, and 8 (6.75-9) in the sham group respectively (Fig. 3D).…”

“…Many advancements in surgical or pharmacological adjuncts, including centrifugal pump distal perfusion techniques, cerebrospinal fluid drainage, hypothermia, and administration of various neuroprotective pharmacologic agents, have been tested and developed to increase spinal cord ischemic tolerance and reduce the spinal cord ischemia reperfusion injury (IRI) [2][3][4]. However, their efficacy is limited and the neural complications remain as high as 15.9% of this group of patients [5].…”