title: Local haemofiltration with free radical scavenger treatment during revascularisation of severe muscular ischaemia induced in sheep limbs.
abstract: Many treatments have been proposed for the prevention of the revascularisation syndrome following embolectomy or thrombectomy in patients with severe ischaemia. These include the administration of diuretics, bicarbonate, buffer solutions, free radical scavengers, washing out the venous blood from the ischaemic leg, or systemic dialysis. The aim of our study was to investigate the effect of combining haemofiltration with a treatment using compound oxy-radical scavengers in order to prevent or to reduce the appearance of the revascularisation syndrome. The study was performed on 13 sheep. Eight animals underwent 4 h of aortic and vena cava occlusion using irrigation-occlusion catheters, followed by normal reperfusion (control group). Five sheep underwent the same period of ischaemia, followed by 1 h of local haemofiltration and re-oxygenation and 2 h of normal revascularisation. The priming solution for the ECC circuit consisted of 500 ml of 20% mannitol and 500 ml of 18/1000 HCO3- contained: superoxide dismutase (150,000 I.U.), methylprednisolone, 1 g, and heparin, 10,000 I.U. After the 3rd h of ischaemia, 2.1 g of acetate alpha-tocopherol (30 mg kg-1) were injected i.m. The treatment produced good protection against oxidative stress, shown by an increase in the glutathione ratio (GSH/GSSG), and reduced muscular damage, confirmed by a moderate increase in creatine phosphokinase (CPK) levels (significantly higher in the control group). Diuresis was significantly higher in the treated group, and the acid-basic and potassium balance returned to normal more rapidly. Our data suggest that this combined treatment could be effective in the prevention of the ischaemia-reperfusion syndrome.
authors.affiliation: Department of Vascular Surgery, University of Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pedrini
authors.forename: E
authors.initials: E
authors.lastname: Pisano
authors.forename: L
authors.initials: L
authors.lastname: Catizone
authors.forename: L
authors.initials: L
authors.lastname: Masetti
authors.forename: A
authors.initials: A
authors.lastname: Muttini
authors.forename: R
authors.initials: R
authors.lastname: Motta
authors.forename: E
authors.initials: E
authors.lastname: Fiocchi
authors.forename: C
authors.initials: C
authors.lastname: Guarnieri
authors.forename: G
authors.initials: G
authors.lastname: Fornino
authors.forename: M
authors.initials: M
authors.lastname: D'Addato
mesh_terms: D000818:Animals; D003402:Creatine Kinase / Q000378:metabolism; D005112:Extracorporeal Circulation / Q000295:instrumentation*; D016166:Free Radical Scavengers; D005978:Glutathione / Q000378:metabolism; D006440:Hemofiltration / Q000295:instrumentation*; D006614:Hindlimb / Q000098:blood supply; D006863:Hydrogen-Ion Concentration; D007511:Ischemia / Q000601:surgery*; D009132:Muscles / Q000098:blood supply*; D010107:Oxygenators, Membrane; D015427:Reperfusion Injury / Q000201:enzymology; D012756:Sheep; D013482:Superoxide Dismutase / Q000008:administration & dosage*
chemical_list: D016166:Free Radical Scavengers; D013482:Superoxide Dismutase; D003402:Creatine Kinase; D005978:Glutathione