OBJECTIVE: Abdominal aortic aneurysm (AAA) surgery subjects the lower extremities to ischemia and reperfusion. Although it is not extensive or prolonged, ischemia of the lower extremities during aortic cross-clamping is gradually and steadily induced. We studied the effects of prostaglandin E1 (PGE1) on ischemia-reperfusion injury of the lower extremities during AAA repair. METHODS: During AAA surgery, two near-infrared spectroscopy probes were positioned on each calf muscle to monitor oxygen metabolism in the lower extremities. We also measured lactate concentration in both iliac veins. RESULTS: Near-infrared spectroscopy signals responded sensitively to aortic cross-clamping and declamping. Lactate increased time-dependently during aortic cross-clamping. The continuous venous administration of PGE1 (20 ng/kg per minute) inhibited the accumulation of lactate during aortic cross-clamping. Declamping of the first iliac artery resulted in a further but transient increase in ipsilateral venous lactate, which may be one component in the mechanism of declamping shock. Prostaglandin E1 eliminated the transient increase in ipsilateral lactate. The administration of PGE1 inhibited the contralateral accumulation of lactate after first declamping, and the lactate level decreased gradually before the second declamping. CONCLUSIONS: Prostaglandin E1 seems to have a protective effect against ischemia-reperfusion injury of the lower extremities during AAA surgery.
OBJECTIVE:Abdominal aortic aneurysm (AAA) surgery subjects the lower extremities to ischemia and reperfusion. Although it is not extensive or prolonged, ischemia of the lower extremities during aortic cross-clamping is gradually and steadily induced. We studied the effects of prostaglandin E1 (PGE1) on ischemia-reperfusion injury of the lower extremities during AAA repair. METHODS: During AAA surgery, two near-infrared spectroscopy probes were positioned on each calf muscle to monitor oxygen metabolism in the lower extremities. We also measured lactate concentration in both iliac veins. RESULTS: Near-infrared spectroscopy signals responded sensitively to aortic cross-clamping and declamping. Lactate increased time-dependently during aortic cross-clamping. The continuous venous administration of PGE1 (20 ng/kg per minute) inhibited the accumulation of lactate during aortic cross-clamping. Declamping of the first iliac artery resulted in a further but transient increase in ipsilateral venous lactate, which may be one component in the mechanism of declamping shock. Prostaglandin E1 eliminated the transient increase in ipsilateral lactate. The administration of PGE1 inhibited the contralateral accumulation of lactate after first declamping, and the lactate level decreased gradually before the second declamping. CONCLUSIONS:Prostaglandin E1 seems to have a protective effect against ischemia-reperfusion injury of the lower extremities during AAA surgery.
Authors: I Huk; V Brovkovych; J Nanobashvili; C Neumayer; P Polterauer; M Prager; S Patton; T Malinski Journal: Shock Date: 2000-08 Impact factor: 3.454
Authors: M H Sketch; A Whelton; E Schollmayer; J A Koch; P J Bernink; F Woltering; J Brinker Journal: Am J Ther Date: 2001 May-Jun Impact factor: 2.688
Authors: G P Novelli; C Adembri; E Gandini; S Z Orlandini; L Papucci; L Formigli; L I Manneschi; A Quattrone; C Pratesi; S Capaccioli Journal: Am J Surg Date: 1997-03 Impact factor: 2.565
Authors: A Gabriel; A Werba; P Mares; G Grubhofer; F Hrska; A Griesmacher; G Kretschmer; F X Lackner; N G Bircher; S Schwarz Journal: J Cardiothorac Vasc Anesth Date: 1996-02 Impact factor: 2.628
Authors: Enrique María San Norberto García; James Henry Taylor; Noelia Cenizo; Carlos Vaquero Journal: Interact Cardiovasc Thorac Surg Date: 2014-01-14