Document Detail


Basic control of reperfusion effectively protects against reperfusion injury in a realistic rodent model of acute limb ischemia.
MedLine Citation:
PMID:  18936330     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Reperfusion injury is insufficiently addressed in current clinical management of acute limb ischemia. Controlled reperfusion carries an enormous clinical potential and was tested in a new reality-driven rodent model. METHODS AND RESULTS: Acute hind-limb ischemia was induced in Wistar rats and maintained for 4 hours. Unlike previous tourniquets models, femoral vessels were surgically prepared to facilitate controlled reperfusion and to prevent venous stasis. Rats were randomized into an experimental group (n=7), in which limbs were selectively perfused with a cooled isotone heparin solution at a limited flow rate before blood flow was restored, and a conventional group (n=7; uncontrolled blood reperfusion). Rats were killed 4 hours after blood reperfusion. Nonischemic limbs served as controls. Ischemia/reperfusion injury was significant in both groups; total wet-to-dry ratio was 159+/-44% of normal (P=0.016), whereas muscle viability and contraction force were reduced to 65+/-13% (P=0.016) and 45+/-34% (P=0.045), respectively. Controlled reperfusion, however, attenuated reperfusion injury significantly. Tissue edema was less pronounced (132+/-16% versus 185+/-42%; P=0.011) and muscle viability (74+/-11% versus 57+/-9%; P=0.004) and contraction force (68+/-40% versus 26+/-7%; P=0.045) were better preserved than after uncontrolled reperfusion. Moreover, subsequent blood circulation as assessed by laser Doppler recovered completely after controlled reperfusion but stayed durably impaired after uncontrolled reperfusion (P=0.027). CONCLUSIONS: Reperfusion injury was significantly alleviated by basic modifications of the initial reperfusion period in a new in vivo model of acute limb ischemia. With this model, systematic optimizations of according protocols may eventually translate into improved clinical management of acute limb ischemia.
Authors:
Florian Dick; Jianhui Li; Marie-Noëlle Giraud; Christoph Kalka; Juerg Schmidli; Hendrik Tevaearai
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-20
Journal Detail:
Title:  Circulation     Volume:  118     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-04     Completed Date:  2008-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1920-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Inselspital, and University of Bern, Berne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Anticoagulants / pharmacology
Disease Models, Animal*
Edema / drug therapy,  physiopathology,  prevention & control
Female
Femoral Artery / physiology,  surgery,  ultrasonography
Heparin / pharmacology
Hindlimb / blood supply*
Laser-Doppler Flowmetry
Male
Muscle Contraction
Peripheral Vascular Diseases / drug therapy,  physiopathology,  prevention & control
Postthrombotic Syndrome / drug therapy,  physiopathology,  prevention & control
Rats
Rats, Wistar*
Regional Blood Flow
Reperfusion Injury / drug therapy,  physiopathology*,  prevention & control*
Tourniquets
Chemical
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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