{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T04:26:55Z","timestamp":1740112015783,"version":"3.37.3"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Barts Health National Health Service Trust"},{"name":"BioResource"},{"name":"National Institute of Health","award":["143355","14\/EE\/00"],"award-info":[{"award-number":["143355","14\/EE\/00"]}]},{"name":"the European Union Horizon 2020 research programme","award":["733203"],"award-info":[{"award-number":["733203"]}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","award":["ET 127\/2-1","ET 127\/1-1","278040814"],"award-info":[{"award-number":["ET 127\/2-1","ET 127\/1-1","278040814"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Spinal cord ischaemia (SCI) remains the most devastating complication after thoraco-abdominal aortic aneurysm (TAAA) repair. Its early detection is crucial if therapeutic interventions are to be successful. Cerebrospinal fluid (CSF) is readily available and accessible to microdialysis (MD) capable of detecting metabolites involved in SCI [i.e. lactate, pyruvate, the lactate\/pyruvate ratio (LPR), glucose and glycerol] in real time. Our aim was to evaluate the feasibility of CSF MD for the real-time detection of SCI metabolites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>In a combined experimental and translational approach, CSF MD was evaluated (i) in an established experimental large animal model of SCI with 2 arms: (a) after aortic cross-clamping (AXC, N\u2009=\u20094), simulating open TAAA repair and (b) after total segmental artery sacrifice (Th4\u2013L5, N\u2009=\u20098) simulating thoracic endovascular aortic repair. The CSF was analysed utilizing MD every 15\u2009min. Additionally, CSF was collected hourly from 6 patients undergoing open TAAA repair in a high-volume aortic reference centre and analysed using CSF MD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In the experimental AXC group, CSF lactate increased 3-fold after 10\u2009min and 10-fold after 60\u2009min of SCI. Analogously, the LPR increased 5-fold by the end of the main AXC period. Average glucose levels demonstrated a 1.5-fold increase at the end of the first (preconditioning) AXC period (0.60\u00b10.14 vs 0.97\u00b10.32\u2009mmol\/l); however, they decreased below (to 1\/3 of) baseline levels (0.60\u00b10.14 vs 0.19\u00b10.13\u2009mmol\/l) by the end of the experiment (after simulated distal arrest). In the experimental segmental artery sacrifice group, lactate levels doubled and the LPR increased 3.3-fold within 30\u2009min and continued to increase steadily almost 5-fold 180\u2009min after total segmental artery sacrifice (P\u2009&amp;lt;\u20090.05). In patients undergoing TAAA repair, lactate similarly increased 5-fold during ischaemia, reaching a maximum at 6\u2009h postoperatively. In 2 patients with intraoperative SCI, indicated by a decrease in the motor evoked potential of &amp;gt;50%, the LPR increased by 200%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>CSF is widely available during and after TAAA repair, and CSF MD is feasible for detection of early anaerobic metabolites of SCI. CSF MD is a promising new tool combining bedside availability and real-time capacity to potentially enable rapid detection of imminent SCI, thereby maximizing chances to prevent permanent paraplegia in patients with TAAA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa124","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T12:51:39Z","timestamp":1584535899000},"page":"629-637","source":"Crossref","is-referenced-by-count":3,"title":["Near real-time bedside detection of spinal cord ischaemia during aortic repair by microdialysis of the cerebrospinal fluid"],"prefix":"10.1093","volume":"58","author":[{"given":"Urszula D","family":"Simoniuk","sequence":"first","affiliation":[{"name":"University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany"},{"name":"Saxon Incubator for Clinical Translation (SIKT), University Leipzig, Leipzig, Germany"},{"name":"Department of Cardiothoracic Surgery, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1742-5841","authenticated-orcid":false,"given":"Josephina","family":"Haunschild","sequence":"additional","affiliation":[{"name":"University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany"},{"name":"Saxon Incubator for Clinical Translation (SIKT), University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantin","family":"von Aspern","sequence":"additional","affiliation":[{"name":"University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany"},{"name":"Saxon Incubator for Clinical Translation (SIKT), University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0114-7114","authenticated-orcid":false,"given":"Michael","family":"Boschmann","sequence":"additional","affiliation":[{"name":"Experimental & Clinical Research Center, a joint co-operation between Charit\u00e9 Universit\u00e4tsmedizin Berlin and Max Delbr\u00fcck Center for Molecular Medicine, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5690-9940","authenticated-orcid":false,"given":"Lars","family":"Klug","sequence":"additional","affiliation":[{"name":"Experimental & Clinical Research Center, a joint co-operation between Charit\u00e9 Universit\u00e4tsmedizin Berlin and Max Delbr\u00fcck Center for Molecular Medicine, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Khachatryan","sequence":"additional","affiliation":[{"name":"Saxon Incubator for Clinical Translation (SIKT), University Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Bianchi","sequence":"additional","affiliation":[{"name":"University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5218-3126","authenticated-orcid":false,"given":"Susann","family":"Ossmann","sequence":"additional","affiliation":[{"name":"University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aung Y","family":"Oo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A","family":"Borger","sequence":"additional","affiliation":[{"name":"University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8224-2390","authenticated-orcid":false,"given":"Christian D","family":"Etz","sequence":"additional","affiliation":[{"name":"University Department of Cardiac Surgery, 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