title: Acute pulmonary injury in a model of ruptured abdominal aortic aneurysm.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the combined insults of hemorrhagic shock and aortic clamping simulating ruptured abdominal aortic aneurysm repair had a synergistic effect on the production of pulmonary injury, indicating remote organ injury.
  
  
  METHODS
  Animals were randomized to one of three groups, infrarenal clamp plus 1 hour of shock, infrarenal clamp plus 2 hours of shock, and supramesenteric clamp plus 1 hour of shock. Each of these groups had four subgroups; sham, shock (mean arterial pressure of 50 mm Hg), clamp, or combined [shock plus clamp]). All animals had a laparotomy with aortic clamping in only the clamp and combined groups. Five hours after clamp removal lung permeability index and neutrophil sequestration were quantified.
  
  
  RESULTS
  Lung permeability index (6.60 +/- 0.63, p < 0.05 vs all other groups) and neutrophil sequestration (3.72 +/- 0.45 vs sham and clamp, p < 0.05) were significantly increased when shock and supramesenteric clamp were combined. After 1 or 2 hours of shock and infrarenal clamping, no increase in lung permeability index was noted, although neutrophil sequestration was increased in the 2-hour shock group.
  
  
  CONCLUSIONS
  These results demonstrate the additive effect of shock and supramesenteric clamping, which initiated a cascade of injurious events that resulted in a rapid pulmonary injury. The high mortality rate related to remote organ failure in ruptured abdominal aortic aneurysm may be related to the synergy of these two injurious processes.
authors.affiliation: Division of Vascular Surgery, Toronto Hospital, Ontario, Canada.
authors.forename: T F
authors.initials: TF
authors.lastname: Lindsay
authors.forename: P M
authors.initials: PM
authors.lastname: Walker
authors.forename: A
authors.initials: A
authors.lastname: Romaschin
mesh_terms: D000818:Animals; D017544:Aortic Aneurysm, Abdominal / Q000150:complications*; D001019:Aortic Rupture / Q000150:complications* / Q000503:physiopathology; D001794:Blood Pressure; D004195:Disease Models, Animal; D008168:Lung / Q000201:enzymology / Q000503:physiopathology; D008297:Male; D010539:Permeability; D009195:Peroxidase / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000503:physiopathology
chemical_list: D009195:Peroxidase