title: Protocol for prevention of spinal cord ischemia after thoracoabdominal aortic surgery.
abstract: OBJECTIVE
  This manuscript was written to present a systemic protocol for the prevention, early detection, and treatment of spinal cord ischemia following open and endovascular thoracoabdominal aortic operations.
  
  
  METHODS
  This protocol was a collaborative effort between surgeons, anesthesiologists and intensivists. It was implemented at our institution in November 2007. Nurses are trained to prevent, rapidly detect and ultimately aid in the treatment of spinal cord ischemia.
  
  
  RESULTS
  Implementation of this protocol has aided in prevention, detection and treatment of spinal cord ischemia in patients after open and endovascular thoracoabdominal aortic operations.
  
  
  CONCLUSIONS
  Standardized care and reliance on trained nursing staff to monitor for symptoms following thoracoabdominal aortic operations are safe and aid in the rapid detection, treatment and reversal of spinal cord ischemia.
authors.affiliation: Division of Cardiothoracic and Vascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA Reilly.Hobbs@uphs.upenn.edu.
authors.forename: Reilly D
authors.initials: RD
authors.lastname: Hobbs
authors.affiliation: Division of Vascular Surgery, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: Brant W
authors.initials: BW
authors.lastname: Ullery
authors.affiliation: Division of Cardiothoracic and Vascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Allison R
authors.initials: AR
authors.lastname: Mentzer
authors.affiliation: Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Albert T
authors.initials: AT
authors.lastname: Cheung
mesh_terms: D001012:Aorta, Abdominal / Q000503:physiopathology / Q000601:surgery*; D001013:Aorta, Thoracic / Q000503:physiopathology / Q000601:surgery*; D065634:Cerebrospinal Fluid Leak; D019091:Critical Pathways; D042241:Early Diagnosis; D006439:Hemodynamics; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*
keywords: Spinal cord ischemia; prophylactic lumbar drainage; reversible spinal cord ischemia; thoracoabdominal aortic surgery