Postconditioning of the lower limb-protection against the reperfusion syndrome

Endre Gyurkovics, Peter Aranyi, Rita Stangl, Peter Onody, Gabor Ferreira, G. Lotz, P. Kupcsulik, Attila Szijarto

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Postconditioning - alternating brief cycles of reperfusion/reocclusion applied at the beginning of revascularization - is a potent therapeutic technique, attenuating ischemia-reperfusion injury. Vascular surgery on the lower limb with ischemia-reperfusion injury may give rise to serious systemic complications [organ dysfunction syndrome (MODS), systemic inflammatory response syndrome (SIRS)], a phenomenon called reperfusion- syndrome. Material and Methods: We studied the effects of postconditioning on reperfusion-syndrome in a rodent experimental model. Wistar rats underwent 180 min of bilateral lower limb ischemia using an infrarenal crossclamping of the abdominal aorta. Postconditioning consisted of six cycles of 10-s aortic occlusion/10-s declamping at the beginning of reperfusion. Microcirculation of the lower limb was detected with laser Doppler flowmeter. After 4 h of reperfusion, plasma, urine, and histologic samples were collected. Results: One hundred eighty-minute ischemia resulted in significant hemodynamic changes after reperfusion. Postconditioning affected the character of the microcirculatory flow, the limb circulation stabilized with hyperemia during reperfusion. Postconditioning caused a significant reduction in systemic inflammatory response (TNF-α, oxygen-derived free radicals). The laboratory and histologic samples implied a significant decrease in distant organ (lung and renal) dysfunctions after postconditioning. Conclusion: Postconditioning proves to be capable of conferring protection against different organ injuries caused by longer circulatory occlusions during elective major vascular operations.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalJournal of Surgical Research
Volume169
Issue number1
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Reperfusion
Lower Extremity
Reperfusion Injury
Blood Vessels
Ischemia
Flowmeters
Systemic Inflammatory Response Syndrome
Multiple Organ Failure
Abdominal Aorta
Hyperemia
Microcirculation
Free Radicals
Wistar Rats
Rodentia
Lasers
Theoretical Models
Extremities
Hemodynamics
Urine
Oxygen

Keywords

  • acute renal failure
  • ischemia-reperfusion injury
  • limb ischemia
  • postconditioning
  • reperfusion syndrome
  • systemic inflammatory response syndrome

ASJC Scopus subject areas

  • Surgery

Cite this

Gyurkovics, E., Aranyi, P., Stangl, R., Onody, P., Ferreira, G., Lotz, G., ... Szijarto, A. (2011). Postconditioning of the lower limb-protection against the reperfusion syndrome. Journal of Surgical Research, 169(1), 139-147. https://doi.org/10.1016/j.jss.2009.10.014

Postconditioning of the lower limb-protection against the reperfusion syndrome. / Gyurkovics, Endre; Aranyi, Peter; Stangl, Rita; Onody, Peter; Ferreira, Gabor; Lotz, G.; Kupcsulik, P.; Szijarto, Attila.

In: Journal of Surgical Research, Vol. 169, No. 1, 07.2011, p. 139-147.

Research output: Contribution to journalArticle

Gyurkovics, E, Aranyi, P, Stangl, R, Onody, P, Ferreira, G, Lotz, G, Kupcsulik, P & Szijarto, A 2011, 'Postconditioning of the lower limb-protection against the reperfusion syndrome', Journal of Surgical Research, vol. 169, no. 1, pp. 139-147. https://doi.org/10.1016/j.jss.2009.10.014
Gyurkovics, Endre ; Aranyi, Peter ; Stangl, Rita ; Onody, Peter ; Ferreira, Gabor ; Lotz, G. ; Kupcsulik, P. ; Szijarto, Attila. / Postconditioning of the lower limb-protection against the reperfusion syndrome. In: Journal of Surgical Research. 2011 ; Vol. 169, No. 1. pp. 139-147.
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