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All forms of surgical therapy are stressful and injurious. The problems of paralysis, renal dysfunction, and colonic ischemia associated with aortic occlusion are due to acute ischemia-reperfusion injury at the cellular level. Acute-anterior spinal cord ischemia is the most devastating outcome of these iatrogenic-ischemic events. The majority of surgical procedures are performed electively and therefore provide an opportunity to preoperatively condition the patient to minimize these ischemia-related morbidities.

journal of thoracic and cardiovascular surgery

Preoperative stress conditioning prevents paralysis after experimental aortic surgery: Increased heat shock protein content is associated with ischemic tolerance of the spinal cord