Preparing the spinal cord - priming or preconditioning? A systematic review of experimental studies.

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Johanna Herajärvi, Tatu Juvonen
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引用次数: 0

Abstract

Objectives. Paraplegia is devastating complication associated with thoracic and thoracoabdominal aortic aneurysm repair. Vast evidence has been gathered on pre-, peri- and postoperative protective adjuncts aiming to minimize spinal cord ischemia. This review focuses on the pretreatment phase of open surgical or endovascular aortic procedures and gathers the experimental data on the interventional preconditioning and priming methods that increase the spinal cord ischemic tolerance. Design. By the start of March 2021, a systematic review was performed in PubMed, Scopus and Web of Science core collection to identify the articles that reported (i) either an ischemic preconditioning, remote ischemic preconditioning or priming method prior to (ii) experimental spinal cord ischemia performed in endovascular or open surgical fashion mimicking either thoracic, abdominal or thoracoabdominal aortic aneurysm procedures. (iii) The outcomes were reported via neurological, motor-evoked potential, somatosensory-evoked potential, histopathological, immunohistochemical, physiological analysis, or in different combinations of these measurements. Results. The search yielded 7802 articles, and 57 articles were included in the systematic review. The articles were assessed by the evaluated species, the utilized pretreatment, the measured protective effects, and the suggested underlying mechanisms. Conclusions. The reviewed articles showed several possible mechanisms in ischemic and remote ischemic preconditioning for prevention of spinal cord ischemia. The main suggested method for priming was arteriogenetic stimulus. Future studies should confirm these hints of arteriogenetic stimulus with more precise quantification of the protective recruitment process.

准备脊髓预处理还是预处理?对实验研究的系统综述。
目标。截瘫是与胸腹主动脉瘤修复相关的毁灭性并发症。已经收集了大量关于术前、围术中和术后保护性附件的证据,旨在最大限度地减少脊髓缺血。这篇综述的重点是开放手术或血管内主动脉手术的预处理阶段,并收集了关于提高脊髓缺血耐受性的介入预处理和预处理方法的实验数据。设计截至2021年3月初,在PubMed、Scopus和Web of Science核心集合中进行了一项系统综述,以确定报告(i)在(ii)以血管内或开放手术方式模拟胸部、,腹部或胸腹主动脉瘤手术。(iii)通过神经、运动诱发电位、体感诱发电位、组织病理学、免疫组织化学、生理学分析或这些测量的不同组合报告结果。后果搜索共产生7802篇文章,系统综述中包括57篇文章。通过评估的物种、使用的预处理、测量的保护作用和建议的潜在机制来评估这些文章。结论。综述了缺血和远程缺血预处理预防脊髓缺血的几种可能机制。主要建议的启动方法是动脉生成刺激。未来的研究应该通过更精确地量化保护性募集过程来证实这些动脉生成刺激的提示。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Scandinavian Cardiovascular Journal
Scandinavian Cardiovascular Journal 医学-心血管系统
CiteScore
3.40
自引率
0.00%
发文量
56
审稿时长
6-12 weeks
期刊介绍: The principal aim of Scandinavian Cardiovascular Journal is to promote cardiovascular research that crosses the borders between disciplines. The journal is a forum for the entire field of cardiovascular research, basic and clinical including: • Cardiology - Interventional and non-invasive • Cardiovascular epidemiology • Cardiovascular anaesthesia and intensive care • Cardiovascular surgery • Cardiovascular radiology • Clinical physiology • Transplantation of thoracic organs
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