title: Effect of prostaglandin E1 on ischemia-reperfusion injury during abdominal aortic aneurysm surgery.
abstract: OBJECTIVE
  Abdominal aortic aneurysm (AAA) surgery subjects the lower extremities to ischemia and reperfusion. Although it is not extensive or prolonged, ischemia of the lower extremities during aortic cross-clamping is gradually and steadily induced. We studied the effects of prostaglandin E1 (PGE1) on ischemia-reperfusion injury of the lower extremities during AAA repair.
  
  
  METHODS
  During AAA surgery, two near-infrared spectroscopy probes were positioned on each calf muscle to monitor oxygen metabolism in the lower extremities. We also measured lactate concentration in both iliac veins.
  
  
  RESULTS
  Near-infrared spectroscopy signals responded sensitively to aortic cross-clamping and declamping. Lactate increased time-dependently during aortic cross-clamping. The continuous venous administration of PGE1 (20 ng/kg per minute) inhibited the accumulation of lactate during aortic cross-clamping. Declamping of the first iliac artery resulted in a further but transient increase in ipsilateral venous lactate, which may be one component in the mechanism of declamping shock. Prostaglandin E1 eliminated the transient increase in ipsilateral lactate. The administration of PGE1 inhibited the contralateral accumulation of lactate after first declamping, and the lactate level decreased gradually before the second declamping.
  
  
  CONCLUSIONS
  Prostaglandin E1 seems to have a protective effect against ischemia-reperfusion injury of the lower extremities during AAA surgery.
authors.affiliation: Department of Cardiovascular Surgery, Oita University, School of Medicine, 1-1 Idaigaoka, Hasama, Oita, 879-5593, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sako
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hadama
authors.forename: Shinji
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Anai
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Wada
authors.forename: Eriko
authors.initials: E
authors.lastname: Iwata
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Hamamoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Keiko
authors.initials: K
authors.lastname: Urushino
authors.forename: Takashi
authors.initials: T
authors.lastname: Shuto
mesh_terms: D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000188:drug therapy*; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D011336:Probability; D011446:Prospective Studies; D011859:Radiography; D012016:Reference Values; D012086:Reoperation; D015427:Reperfusion Injury / Q000188:drug therapy* / Q000209:etiology; D018570:Risk Assessment; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects
chemical_list: D000527:Alprostadil