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 does occur it significantly alters the patient's outcome. Poloxamer 188 (P188) has been shown in the experimental animal to increase regional blood flow to ischemic areas. In order to investigate its protective effect during aortic cross-clamping, 23 animals were randomized to two groups (placebo n = 11, P188n = 12) and received an intravenous injection of placebo or P188 (200 mg/kg), and underwent occlusion of the thoracic aorta and both subclavian arteries for a period of 13 minutes. They were then connected to an intravenous pump delivering either placebo or P188 (250 mg/kg/hr at a rate of 0.942 ml/hour) for 48 hours. Hindlimb function was appraised, daily for 30 days, by a lesion score (0-15). Spinal cord injury was assessed by a histologic score (0-3) based on the degree of gray and white matter gliosis, number of motor neurons, and white matter myelination. Analysis of variance for repeated measures did not reveal significant difference between P188 and placebo groups (P = 0.66). Similarly, the mean histologic scores (placebo = 1.54 +/- 0.41 SE, P188 = 1.08 +/- 0.33 SE) did not differ (Wilcoxon, P = 0.43). We conclude that intravenous administration of P188 before, during, and for 48 hours after aortic cross-clamping does not prevent paraplegia or improve the long term neurologic outcome.