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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2001 June;20(2):174-80

lingua: Inglese

The effect of pretreatment with ischaemic preconditioning or cromakalim on perfusion in skeletal muscle during ischaemia-reperfusion injury

Seifalian A. M., Chaloupka K. *, Lohn J. W., Gürke L. *, Heberer M. *, Hamilton G.

From the Vas­cu­lar Hae­mod­y­nam­ic Labor­a­to­ry, Uni­ver­sity Depart­ment of Sur­gery, Royal Free and Uni­ver­sity Col­lege Med­i­cal ­School, Uni­ver­sity College Lon­don and The Royal Free Hos­pi­tal, Lon­don, UK
* Depart­ment for Sur­gi­cal ­Research, Uni­ver­sity Hos­pi­tal of Basel, Basel, Swit­zer­land


Back­ground. Ischae­mia-­induced dam­age of skel­e­tal mus­cle may lead to side ­effects in ortho­paed­ic and recon­struc­tive sur­gery where tour­ni­quet ischae­mia is ­applied to ­ensure a blood­less oper­a­tive field. In this study we inves­ti­gat­ed the ­effect of ischae­mia-reper­fu­sion inju­ry with and with­out pre­con­di­tion­ing by stud­y­ing the skel­e­tal mus­cle micro­cir­cu­la­tion. A fur­ther aim was to estab­lish wheth­er ischaem­ic pre­con­di­tion­ing or pretreat­ment with cro­mak­a­lim, a potas­sium chan­nel open­er reduc­es ischaem­ia-reper­fu­sion inju­ry.
Meth­ods. Twen­ty-eight ­Wistar rats were ran­dom­ised into four ­groups (n=7 per group). Group 1, con­trol with no treat­ment; Group 2, two and a half hours tour­ni­quet ischae­mia fol­lowed by two hours of reper­fu­sion to the left hind­limb. Fur­ther­more, we pre-treat­ed two ­groups prior to the ischae­mia-reper­fu­sion peri­od; Group 3 with three short ­cycles of ischaem­ia-reper­fu­sion (5’/5’) and Group 4 pre treat­ed with cro­mak­a­lim (100 µg/kg bw). We mon­i­tored the gas­troc­ne­mi­us mus­cle blood flow in vivo.
­Results. There were no sig­nif­i­cant chang­es in the skel­e­tal mus­cle micro­cir­cu­la­tion and tem­per­a­ture at the base­line in the four ­groups (p=0.110). In the ischaem­ic reper­fu­sion, ischae­mia pre­con­di­tion­ing and cro­mak­a­lim ­groups, the record­ed skel­e­tal mus­cle micro­cir­cu­la­tion dur­ing ischae­mia ­decreased sig­nif­i­cant­ly (p<0.001) with ­respect to the base­line. In Group 2 the micro­cir­cu­la­tion recov­ered rap­id­ly after ­release of the tour­ni­quet, but was sig­nif­i­cant­ly lower (37% of base­line value, p<0.001) with­in two hours of reper­fu­sion. In the ischae­mia pre­con­di­tion­ing group the micro­cir­cu­la­tion as in the ischae­mia-reper­fu­sion group recov­ered rap­id­ly after ­release of the tour­ni­quet, ­although fail­ing to reach the base­line value with­in two hours of reper­fu­sion. The mean micro­cir­cu­la­tion value of the left limb was slight­ly high­er than Group 2 but sig­nif­i­cant­ly lower com­pared to the base­line after two hours of reper­fu­sion (p<0.001). The ­change in the skel­e­tal mus­cle micro­cir­cu­la­tion with cro­mak­a­lim after two hours of reper­fu­sion was not sig­nif­i­cant when com­pared to base­line val­ues (p>0.05). The cro­mak­a­lim group after two hours reper­fu­sion had sig­nif­i­cant­ly high­er micro­cir­cu­la­tion val­ues when com­pared with ­Groups 2 and 3 (p<0.001). Dur­ing ischaem­ia-reper­fu­sion in ­Groups 2-4, there was no sig­nif­i­cant alter­a­tion in the system­ic hae­mod­y­nam­ic cir­cu­la­tion.
Con­clu­sions. This study sup­ports the hypoth­e­sis that cro­mak­a­lim reduc­es postischaem­ic skel­e­tal mus­cle dam­age and reper­fu­sion inju­ry.

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