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Ann Thorac Surg 2005;80:1829-1833
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

An Epidural Cooling Catheter Protects the Spinal Cord Against Ischemic Injury in Pigs

^a Department of Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
^b Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
^c Department of Physiology, Keio University School of Medicine, Tokyo, Japan

Accepted for publication April 22, 2005.

^_* Address correspondence to Dr Mori, Department of Cardiovascular Surgery, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Konancho, Osatogun, Saitama, 360–0105, Japan (Email: mori_atsuo{at}hotmail.com).

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.

This article has been cited by other articles:

				A. Yoshitake, A. Mori, H. Shimizu, T. Ueda, N. Kabei, T. Hachiya, H. Okano, and R. Yozu Use of an epidural cooling catheter with a closed countercurrent lumen to protect against ischemic spinal cord injury in pigs. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1220 - 1226. [Abstract] [Full Text] [PDF]

				J. D. Galla Invited commentary Ann. Thorac. Surg., November 1, 2005; 80(5): 1833 - 1834. [Full Text] [PDF]