HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gelman, S. Articles by Smith, L. R. Search for Related Content PubMed PubMed Citation Articles by Gelman, S. Articles by Smith, L. R.

The Journal of Thoracic and Cardiovascular Surgery, Vol 85, 287-291, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Regional blood flow during cross-clamping of the thoracic aorta and infusion of sodium nitroprusside

S Gelman, JG Reves, K Fowler, PN Samuelson, WA Lell and LR Smith

Labeled microspheres, 15 microns in diameter, were used to determine cardiac output and regional blood flow response to cross-clamping of the midthoracic aorta and subsequent sodium nitroprusside (SNP) infusion in 11 dogs. During aortic cross-clamping, mean arterial pressure above the occlusion (MAPa) increased 30% to 35%, mean arterial pressure below the occlusion (MAPb) decreased 87%, cardiac index decreased 12% to 14%, left atrial pressure (LAP) doubled, and renal and spinal cord (lower part) blood flows decreased substantially (85% to 94%). SNP infusion returned MAPa to baseline values, decreased MAPb by half, and substantially and further decreased renal blood flow (to 3% to 5% of baseline values). Myocardial and cerebral blood flows increased substantially (up to 250% to 400%). An increase in preload (fluid load) was accompanied by an increase in LAP, cardiac index, and myocardial blood flow only but not in renal or spinal cord flow. There was a strong association between cortical renal blood flow and MAPb (r2 = 0.92; p less than 0.0001), which suggests that blood flow through organs and tissues below the occlusion is pressure dependent. The data show that SNP infusion during thoracic aortic cross-clamping improves systemic and regional circulation above the occlusion but decreases MAPb and therefore blood flow below the occlusion. SNP infusion should be used with caution during aortic cross-clamping, since arterial hypotension of any degree may be deleterious to organs below the cross- clamp.

This article has been cited by other articles:

				T. Annecke, J. C. Kubitz, S. Kahr, J. M. Hilberath, K. Langer, G. I. Kemming, M. Rehm, I. Bittmann, and P. F. Conzen Effects of sevoflurane and propofol on ischaemia-reperfusion injury after thoracic-aortic occlusion in pigs Br. J. Anaesth., May 1, 2007; 98(5): 581 - 590. [Abstract] [Full Text] [PDF]

				L. Lang-Lazdunski, J. Bachet, and C. Rogers Repair of the descending thoracic aorta: impact of open distal anastomosis technique on spinal cord perfusion, neurological outcome and spinal cord histopathology Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 351 - 358. [Abstract] [Full Text] [PDF]

				J. S. Coselli and P. L. Moreno Descending and Thoracoabdominal Aneurysm Card. Surg. Adult, January 1, 2003; 2(2003): 1169 - 1190. [Full Text]

				E. A. Hessel Bypass Techniques for Descending Thoracic Aortic Surgery Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 293 - 320. [Abstract] [PDF]

				G. M. Wilcox, S. A. Harlin, M. L. Miller, W. D. Newton, B. D. Peyton, and A. G. Lane Distal Aortic Perfusion and Theophylline in the Augmentation of Postischemic Renal Blood Flow Vascular and Endovascular Surgery, September 1, 2000; 34(5): 419 - 428. [Abstract] [PDF]

				B V S Murthy, H D Waiker, K Neelakanthan, and K M. Das Hyperkalaemia following blood transfusion Postgrad. Med. J., August 1, 1999; 75(886): 501 - 503. [Full Text]

				A. N. Katsamouris, G. T. Mastrokostopoulos, N. S. Hatzinikolaou, D. G. Lappas, and M. J. Buckley Control of Left Ventricular and Proximal Aortic Dimensional Decompensation During Clamping of Descending Thoracic Aorta Vascular and Endovascular Surgery, September 1, 1988; 22(5): 316 - 327. [Abstract] [PDF]