Indices of muscular damage in the perioperative period of peripheral revascularization procedures.
OBJECTIVE
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.


METHODS
CK and Mb levels were measured immediately before intervention, 24 and 48 h postoperatively, and were compared in each group. Patients with CK >1,000 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 >1,000 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 1,000 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.


CONCLUSIONS
Persistently increased CK and Mb at 48 h after a peripheral revascularization procedure are consistent with a significant ischemia-reperfusion injury.
Olivei
M C
MC
Anesthesia A Unit, San Giovanni Bosco Hospital, ASL 4, Turin, Italy.
Sosso
E
E
Suckzs Ventimiglia
K
K
Macchiarulo
R
R
Quatrocchio
G
G
Guglielmotti
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D011183:Postoperative Complications / Q000473:pathology*; D012206:Rhabdomyolysis / Q000209:etiology* / Q000473:pathology*; D014656:Vascular Surgical Procedures
D015415:Biomarkers; D009211:Myoglobin; D003402:Creatine Kinase