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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTHESIA
Minerva Anestesiologica 2004 December;70(12):793-9
language: English, Italian
Indices of muscular damage in the perioperative period of peripheral revascularization procedures
Olivei M. C. 1, Sosso E. 1, Suckzs Ventimiglia K. 1, Macchiarulo R. 1, Quatrocchio G. 2, Guglielmotti E. 1
1 Anesthesia A Unit San Giovanni Bosco Hospital, ASL 4, Turin, Italy
2 Nephrology Unit San Giovanni Bosco Hospital, ASL 4, Turin, Italy
Aim. We evaluated the perioperative levels of plasma myoglobin (Mb) and creatine kinase (CK) in patients submitted to peripheral revascularization surgery for a variety of conditions.
Methods. Design and setting: observational study in a surgical ward of a community hospital. Subjects: 50 consecutive patients were included in the study: 30 were admitted for elective peripheral revascularization (Group 1), 10 for urgent peripheral revascularization (Group 2), and 10 for major elective abdominal surgery with minimal risk of rhabdomyolysis. These latter patients served as Control Group. Interventions: CK and Mb levels were measured immediately before intervention, 24 and 48 h postoperatively, and were compared in each group. Patients with CK >1000 UI/l within this period were submitted to standard prophylaxis of acute renal failure (ARF), and further monitored.
Results. Preoperative values of CK and Mb were normal in Group 1 and Control Group, but not in Group 2. After the intervention, CK and Mb levels increased in all groups, although in a different degree. This increase was maximal in Group 2, where 9 patients showed CK >1000 UI/l within the first 48 postoperative hours, and were submitted to ARF prophylaxis. In Group 1 CK and Mb values increased moderately, and maximal CK values were below 1000 UI/l in all cases. The postoperative increase in CK and Mb values was minimal in Control Group, where these parameters were already in the normal range 48 hours after the intervention.
Conclusion. Persistently increased CK and Mb at 48 h after a peripheral revascularization procedure are consistent with a significant ischemia-reperfusion injury.