Mechanical Circulatory Support During Repair of Thoracic Aortic Injuries Improves Morbidity and Prevents Spinal Cord Injury

摘要: Objective: Evaluation of mechanical circulatory support (MCS) vs simple cross clamping (CC) during repair traumatic descending thoracic aortic transections. Design: A retrospective analysis all patients admitted with blunt injury to the aorta from August 1988 through March 1993. Patients were pseudorandomized CC MCS according on-call surgeons' preferences. Setting: level 1 trauma center in Seattle, Wash. Patients: Forty-two admitted. Thirty (71%) survived, 21 whom underwent and nine only. Intervention: Prompt was performed either primarily or by replacement a Dacron graft. Main Outcome Measures: Operative survivors examined for new neurologic deficits, renal function, pulmonary failure, gastrointestinal tract complications, sepsis, length hospitalization. Causes death determined. Results: Twelve died, seven before surgery five surgery. In survivors, deficits occurred four (44%) undergoing none ( P =.0005). Mean (±SEM) postoperative serum creatinine levels higher (256±80 μmol/L [2.9±0.9 mg/dL]) than (115±18 [1.3±0.2 Conclusions: Mechanical extracorporeal perfusion distal occlusion injuries may prevent spinal cord ischemia reduce organ dysfunction. (Arch Surg. 1994;129:494-498)