Rapidly progressing fatal reperfusion syndrome caused by acute critical ischemia of the lower limb

Szíjártó, Attila; Turóczi, Zsolt; Szabó, József; Kaliszky, Péter; Gyurkovics, Endre; Arányi, Péter; Regáli, László; Harsányi, László; Lotz, Gábor

doi:10.1016/j.carpath.2013.02.006

Cited by 15 publications

(10 citation statements)

References 6 publications

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“…A dysfunction of both sodium‐potassium ATPase and calcium‐sodium exchanger is also involved; elevated levels of free calcium interact with actin, myosin and cellular proteases, resulting in skeletal muscle fibre necrosis. These events are amplified by reperfusion . Local complications of I/R injury may also result in amputation or severe dysfunction in the salvaged limbs .…”

Section: Discussionmentioning

confidence: 99%

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Biomarkers in post‐reperfusion syndrome after acute lower limb ischaemia

Franciscis

Caridi

Massara

et al. 2014

International Wound Journal

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Ischaemia reperfusion (I/R) injury refers to tissue damage caused when blood supply returns to the tissue after a period of ischaemia. Matrix metalloproteinases (MMPs), neutrophil gelatinase-associated lipocalin (NGAL) and cytokines are biomarkers involved in several vascular complications. The aim of this study was to evaluate the role of MMPs, NGAL and inflammatory cytokines in I/R syndrome. We conducted an open label, multicentric, parallel group study, between January 2010 and December 2013. Patients with acute limb ischaemia were enrolled in this study and were divided into two groups: (i) those subjected to fasciotomy and (ii) those not subjected to fasciotomy, according to the onset of compartment syndrome. Plasma and tissue values of MMPs and NGAL as well as plasma cytokines were evaluated. MMPs, NGAL and cytokine levels were higher in patients with compartment syndrome. Biomarkers evaluated in this study may be used in the future as predictors of I/R injury severity and its possible evolution towards post-reperfusion syndrome.

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Section: Discussionmentioning

confidence: 99%

“…These events are amplified by reperfusion . Local complications of I/R injury may also result in amputation or severe dysfunction in the salvaged limbs . I/R injury of an extensive muscle tissue mass and the sensitive vascular tissues and endothelium often leads to systemic complications, a phenomenon called PRS .…”

Section: Discussionmentioning

confidence: 99%

Biomarkers in post‐reperfusion syndrome after acute lower limb ischaemia

Franciscis

Caridi

Massara

et al. 2014

International Wound Journal

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“…Так, включення кровотоку ішемізованих ділянок нижніх кінцівок тільки збільшує ноцицептивну стимуляцію. Реперфузійний синдром має прояви у вигляді посилення больового синдрому, післяоперціного набряку та збільшення зони трофічних змін [10].…”

Section: Original Researchesunclassified

Варіанти Періопераційного Знеболювання Хворих Із Критичною Ішемією Нижніх Кінцівок, Що Прооперовані Методом Ендоваскулярної Балонопластики

Dziuba¹,

Nedashkivskyi²,

Zlоchevskyi³

2022

ЕМ

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Найбільш сучасним методом лікування критичної ішемії нижніх кінцівок є ендоваскулярна балонопластика. З метою оптимізувати інтраопераційну анестезіологічну тактику для знеболювання було використано епідуральну анальгезію та інфузію розчину лідокаїну. Матеріали та методи. 45 пацієнтів були рандомізовані та розподілені на 3 групи по 15 осіб. Хворим І групи проводили аналгоседацію, ІІ групи — внутрішньовенне введення розчину лідокаїну, ІІІ групи — сакральну анестезію. Результати. Застосування як епідуральної, так і внутрішньовенної анальгезії забезпечувало адекватний рівень як інтра-, так і післяопераційної анальгезії при балонопластиці облітеруючого атеросклерозу нижніх кінцівок.

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“…Depending on the skeletal muscle mass subjected to I/R and the duration of ischemia, systemic inflammation and remote organ failure can occur following an increase in enzymes and cellular molecules in the systemic circulation, a phenomenon known as "crush syndrome" (173). Several proinflammatory cytokines produced during I/R, especially TNF␣ and IL-1, can mediate lung failure (167).…”

Section: Phenomena Associated With Skeletal Muscle Injuries Followingmentioning

confidence: 99%

Chronology of mitochondrial and cellular events during skeletal muscle ischemia-reperfusion

Paradis

Charles

Meyer

et al. 2016

American Journal of Physiology-Cell Physiology

127

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Peripheral artery disease (PAD) is a common circulatory disorder of the lower limb arteries that reduces functional capacity and quality of life of patients. Despite relatively effective available treatments, PAD is a serious public health issue associated with significant morbidity and mortality. Ischemia-reperfusion (I/R) cycles during PAD are responsible for insufficient oxygen supply, mitochondriopathy, free radical production, and inflammation and lead to events that contribute to myocyte death and remote organ failure. However, the chronology of mitochondrial and cellular events during the ischemic period and at the moment of reperfusion in skeletal muscle fibers has been poorly reviewed. Thus, after a review of the basal myocyte state and normal mitochondrial biology, we discuss the physiopathology of ischemia and reperfusion at the mitochondrial and cellular levels. First we describe the chronology of the deleterious biochemical and mitochondrial mechanisms activated by I/R. Then we discuss skeletal muscle I/R injury in the muscle environment, mitochondrial dynamics, and inflammation. A better understanding of the chronology of the events underlying I/R will allow us to identify key factors in the development of this pathology and point to suitable new therapies. Emerging data on mitochondrial dynamics should help identify new molecular and therapeutic targets and develop protective strategies against PAD.peripheral artery disease; ischemia-reperfusion; skeletal muscle; mitochondria; oxidative stress PERIPHERAL ARTERY DISEASE (PAD) refers to a common circulatory disorder of the lower limb caused by chronic narrowing of the arteries (e.g., stenosis and occlusion) or atherosclerosis. PAD represents a broad spectrum of disease severity, ranging from asymptomatic disease to frequent pain when walking (i.e., intermittent claudication or limping) or critical limb ischemia associated with decubitus pain and/or ulcers (114,126).PAD is known to be associated with reduced functional capacity and quality of life. It is a major cause of limb amputation, as well as an increased risk factor for myocardial infarction, stroke, and death. The incidence of PAD varies with age, from 3-10% in young people to 15-20% in people Ͼ70 yr of age, and is asymptomatic in 40% of the cases (1), with greater prevalence among men. The major PAD risk factors, including smoking, diabetes mellitus, dyslipidemia, hypertension, and obesity, are the same as those for cardiovascular and cerebrovascular diseases (35).Three main complementary treatment options improve the functional status and other clinical outcomes in PAD patients (54). 1) Optimization of medical therapy (i.e., pharmacotherapy) reduces the risk of cardiac ischemia, increases the distance a patient can walk, and improves the functional capacity of patients. 2) When possible, exercise training, a noninvasive and nonpharmacological therapy, improves walking ability and has protective effects in patients with PAD characterized by intermittent claudication and infrainguinal lesions...

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Rapidly progressing fatal reperfusion syndrome caused by acute critical ischemia of the lower limb

Cited by 15 publications

References 6 publications

Biomarkers in post‐reperfusion syndrome after acute lower limb ischaemia

Biomarkers in post‐reperfusion syndrome after acute lower limb ischaemia

Варіанти Періопераційного Знеболювання Хворих Із Критичною Ішемією Нижніх Кінцівок, Що Прооперовані Методом Ендоваскулярної Балонопластики

Chronology of mitochondrial and cellular events during skeletal muscle ischemia-reperfusion

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