ROLE OF POLOXAMER-188 DURING RECOVERY FROM ISCHEMIC SPINAL-CORD INJURY - A PRELIMINARY-STUDY

Paraplegia following aortic surgery is not a common event. When it doe s occur it significantly alters the patient's outcome. Poloxamer 188 ( P188) has been shown in the experimental animal to increase regional b loodflow to ischemic areas. In order to investigate its protective eff ect during aortic cross-clamping, 23 animals were randomized to two gr oups (placebo n = 11, P188 n = 12) and received an intravenous injecti on of placebo or P188 (200 mg/kg), and underwent occlusion of the thor acic aorta and both subclavian arteries for a period of 13 minutes. Th ey were then connected to an intravenous pump delivering either placeb o or P188 (250 mg/kg/hr at a rate of 0.942 ml/hour) for 48 hours. Hind limb function was appraised, daily for 30 days, by a lesion score (0-1 5). Spinal cord injury was assessed by a histologic score (0-3) based on the degree of gray and white matter gliosis, number of motor neuron s, and white matter myelination. Analysis of variance for repeated mea sures did nor reveal significant difference between P188 and placebo g roups (P = 0.66). Similarly, the mean histologic scores (placebo = 1.5 4 +/- 0.41 SE, P188 = 1.08 +/- 0.33 SE) did not differ (Wilcoxon, P = 0.43). We conclude that intravenous administration of P188 before, dur ing, and for 48 hours after aortic cross-clamping does nor prevent par aplegia or improve the long term neurologic outcome.