Spinal cord ischemia after descending thoracic aortic surgery

This algorithm summarizes our suggested approach to managing evidence of spinal cord ischemia manifesting as paraparesis/paraplegia in the postoperative period after descending thoracic aortic surgery. It is intended for use in conjunction with additional UpToDate content discussing management after descending thoracic aortic surgery.

CSF: cerebrospinal fluid; CVP: central venous pressure; Hgb: hemoglobin; MAP: mean arterial pressure; O₂: oxygen; PaO₂: partial pressure of arterial oxygen; SCPP: spinal cord perfusion pressure.

* Interventions to improve spinal cord perfusion are often performed simultaneously.

¶ Placement/replacement of an intrathecal catheter is desirable but may not possible due to coagulopathy or suspicion for epidural hematoma.

Δ Limit CSF drainage to <20 mL during the first hour of surgery and <40 mL during any four-hour period.

◊ In some cases, there are no additional options to eliminate postoperative spinal cord ischemia.

Graphic 143544 Version 1.0

خرید پکیج

Spinal cord ischemia after descending thoracic aortic surgery