The Greek e-journal of Perioperative Medicine

1-10

Authors: Papaioannou V, Dragoum anis Ch

Cell protection against hypoxia can be mediated by brief periods of sublethal ischemia, a phenomenon called ‘preconditioning’. The molecular mechanisms that are responsible for cell protection are extremely complicated; however, extensive research in molecular biology and cellular physiology has uncovered many different signaling pathways, especially in cardiac tissues. Except for ischemia, it seems that many anesthetic medications, such as volatile anesthetics and opioids, can induce or alter different signaling cascade reactions associated with cell rescue from oxygen lack. The above phenomenon is called anesthetic preconditioning and is considered to be highly cardio-protective.

21-34

Authors: Petrou A, Skubas N

This article aims at presenting the anesthetic and surgical techniques used to preserve spinal cord integrity during thoracoabdominal aortic aneurysm (ΤΑΑΑ – ThoracoAbdominal Aortic Aneurysm) repair operations. The understanding of the pathophysiology of ischemic insult to the spinal cord is considered fundamental in order to choose monitoring and anesthetic techniques during surgical repair of TAAA with or without clamping and when using intravascular stents. The clinical validity of available monitoring modes will also be discussed in accordance with the different aspects of surgical and anesthetic management of intravascular repair as well as the partial bypass maneuver during open surgical repair of TAAA

50-57

Authors: Kiparissa M, Grosomanidis V, Kotzampa ssi A, Pistofidou K, Kolettas A, Vasilakos D, Karakoulas K, Setzis D, Skourtis Ch

Pulmonary capillary pressure (Pcp) is the primary driving force determining the fluid flux across pulmonary capillary wall. Alterations of Pcp have been described in systemic inflammation, sepsis, ARDS, hypoxaemia and acute heart failure. The purpose of this study was to examine the Pcp alterations after lipopolysaccharide (LPS) intravenous administration in pigs. LPS has been administered (150μg/Kg BW) in the right atrium of 8 anesthetized and mechanical ventilated pigs (Group A) and the Pcp was calculated from pulmonary artery pressure tracings using the Gaar equation before, after LPS infusion and in 20min intervals for two hours. As control group served 8 pigs under similar conditions and normal saline administration (Group B). In group A significant increases of Pcp (p<0,01) have been observed directly after LPS infusion (baseline 7.23±0.9 to maximum 18.1±2.3 mmHg) which remained elevated until the end of the experiment. Group B showed no significant changes of Pcp at all. Comparison of A and B groups measurements revealed high significance (p<0,001) at all time intervals. Pulmonary Artery Occlusion Pressure showed no changes in both groups. Our study showed that endotoxin intravenous administration is significantly alterating the pulmonary capillary pressure in pigs under anesthesia and mechanical ventilation. On the contrary the pulmonary artery occlusion pressure was not been affected by the endotoxin administration during our observation. This finding may be important, because under specific circumstances such Pcp increases may lead to fluid extravasation and pulmonary oedema.