The effect of total spinal anesthesia on cardiac function in a large animal model of brain death

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DOIResolve DOI: http://doi.org/10.1139/Y2012-026
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TypeArticle
Journal titleCanadian Journal of Physiology and Pharmacology
ISSN0008-4212
Volume90
Issue9
Pages12871293; # of pages: 7
Subjectadrenalin; catecholamine; noradrenalin; sodium chloride; adrenalin blood level; animal experiment; animal model; article; balloon catheter; blood pressure; brain death; catecholamine blood level; controlled study; heart function; heart rate; high performance liquid chromatography; intracerebral balloon tipped catheter; nonhuman; noradrenalin blood level; nuclear magnetic resonance imaging; priority journal; spinal anesthesia; swine; total spinal anesthesia
AbstractBrain death (BD) causes cardiac dysfunction in organ donors, attributable to the catecholamine storm that occurs with raised intracerebral pressure (ICP). However the direct contribution of the spinal sympathetics has not been well described. We examined the effect of total spinal anesthesia (TSA) on cardiac function in a large animal model of BD. Eighteen pigs were allocated to 3 experimental groups: Group 1, the saline-treated control group; Group 2, TSA administered prior to BD; and Group 3, TSA administered 30 min after BD. Inflation of an intracerebral balloon-tipped catheter was used to induce BD. Ventricular function was assessed using a pressure-volume loop catheter and magnetic resonance imaging. Serum catecholamine levels were assessed with high performance liquid chromatography. Inflation of the intracerebral balloon-tipped catheter was associated with a dramatic rise in heart rate and blood pressure, along with increased concentrations of serum epinephrine and norepinephrine. This phenomenon was not observed in Group 2. In Group 1, there was a significant decline in contractility, whereas groups 2 and 3 saw no change. Group 2 had greater contractile reserve than groups 1 and 3. Our data demonstrate the central role of spinal sympathetics in the hemodynamic response to raised ICP. Further work is required to determine the utility of TSA in reversing cardiac dysfunction in BD donors.
Publication date
LanguageEnglish
AffiliationNational Research Council Canada (NRC-CNRC); NRC Institute for Biodiagnostics (IBD-IBD)
Peer reviewedYes
NPARC number21269443
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Record identifierda60b94b-60b8-4c7d-965a-c35db495e01e
Record created2013-12-12
Record modified2016-05-09
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