Hematological and hemostaseological alterations after warm and cold limb ischemia-reperfusion in a canine model.
OBJECTIVE
Acute ischemia-reperfusion (I/R) of extremities means serious challenge in the clinical practice. Furthermore, the issue of preventive cooling is still controversial. In this canine model we investigated whether limb I/R -with or without cooling- has an influence on hematological and hemostaseological factors.


METHODS
Femoral vessels were exposed and clamped for 3 hours. After release the clamps, 4-hour reperfusion was secured. The same procedures with cooling using ice bags, as well as warm and cold sham-operations were performed. Before operations, from the excluded limb by the end of ischemia, during the reperfusion, and for 5 postoperative days afterwards blood samples were collected for testing hematological and blood coagulation parameters.


RESULTS
After I/R activated partial thromboplastin time was elongated on 2nd-4th postoperative days. The highest values were on the 2nd day in cold I/R group, accompanied by increased prothrombin time values. The hematological parameters and fibrinogen level showed non-specific changes. In excluded ischemic limb the blood composition showed controversial data. Cold ischemia induced larger alterations, however platelet count, hematocrit changed more expressly in warm ischemia.


CONCLUSIONS
These results indicate the risk of coagulopathy following limb I/R on early post-eventually days, which risk is higher in the case of cold I/R.
National Institute of Traumatology, Budapest.
Miklos
M
Szokoly
Norbert
N
Nemeth
Istvan
I
Furka
Iren
I
Miko
D000818:Animals; D001778:Blood Coagulation Disorders / Q000097:blood* / Q000209:etiology; D001831:Body Temperature; D003080:Cold Temperature / Q000009:adverse effects*; D004195:Disease Models, Animal; D004285:Dogs; D005340:Fibrinogen / Q000032:analysis; D018056:Hemorheology; D006487:Hemostasis; D006614:Hindlimb / Q000098:blood supply*; D007511:Ischemia / Q000097:blood*; D035002:Lower Extremity / Q000098:blood supply*; D011897:Random Allocation; D015427:Reperfusion Injury / Q000097:blood* / Q000150:complications
D005340:Fibrinogen