The following report is a study of factors involved in extending the application of hypothermia toward the attainment of a bloodless abdominal field. Since the modernization of hypothermia following the pioneer work of Bigelow,1-4 the use of the technique in cardiac and intracranial surgery has become well known. Relatively little has been written, however, on the possible advantages of prolonged occlusion of the abdominal aorta at a high level, such as would be required to arrest the circulation in the entire abdominal field.
Of the various tissues subject to ischemic damage by aortic occlusion at any level, the spinal cord appears to be the most vulnerable. This fact has been demonstrated by several workers, perhaps most clearly by Pontius et al.5 They also demonstrated that the ischemic damage was enhanced when intercostal vessels were ligated at the same time. Others have reported the safe time of occlusion of
HYNDMAN WWB, GOODALL RGW, GURD FN. Studies on Hypothermia in Abdominal SurgeryI. Occlusion of the Abdominal Aorta Above the Celiac Axis. AMA Arch Surg. 1957;75(4):500-505. doi:10.1001/archsurg.1957.01280160010002