Postconditioning attenuates remote organ injury after lower limb arterial occlusion

Abstract

Introduction External aortic compression due to acute gastric dilation is a rare etiology of the lower limb ischemia. This phenomenon leads the author to design experimental study for reperfusion syndrome. The lower limb ischemia-reperfusion (IR) injury consists of local and systemic components called the reperfusion syndrome. It can progrediate into a multi-organ failure which defines postoperative survival. A postconditioning is a surgical technique, which has a potential to reduce IR injury, therefore to prohibit the development of reperfusion syndrome. Aim XXXto examine on an experimental model, whether postonditioning is a practicable technique in infarenal aortic surgeries. Materials and Methods Male Wistar rats underwent 180 minutes of infrarenal aortic occlusion with 4, 24 and 72 hours of reperfusion. Postconditioning (10 sec. reocclusion / 10 sec. perfusion in 6 cycles) was applied in one group of each reperfusion time. Blood, urine, and histological (muscle, lung, kidney and liver) samples were collected at the postischemic 4th, 24th, and 72th hour. Results The early inflammatory response (TNFa, free radicals) and late local inflammation were reduced by posctonditioning significantly. Postconditioning was able to reduce the remote organ injury of lungs and kidneys, the morphological and laboratorial results showed significant difference between the postconditioning and the control group in these two organs. The method's positive effect on remote organ injury remained long-term. Conclusion Postconditioning seems to be an applicable process to reduce both local inflammatory and systemic complications of IR injury following vascular surgeries.

Attenuation of Skeletal Muscle and Renal Injury to the Lower Limb following Ischemia-Reperfusion Using mPTP Inhibitor NIM-811

“…Based on our earlier investigations, attenuation of local IR damage can reduce the risk of remote organ injury (i. e. in the kidneys) [13] – [15] . During IR, opening of the mPTP plays a pivotal role in cell injury, thus inhibition of the pore opening may mitigate the damages.…”