title: Effect of Shenmai injection, a traditional Chinese medicine, on pulmonary dysfunction after tourniquet-induced limb ischemia-reperfusion.
abstract: BACKGROUND
  Tourniquet has been considered as a recognized cause of lower limb ischemia-reperfusion injury in the orthopedic field. This study investigates pulmonary function after tourniquet deflation and the protective effect of Shenmai injection (SMI), a traditional Chinese medicine.
  
  
  METHODS
  Twenty-eight patients undergoing lower extremity surgery were randomized into a control group (group C) and a SMI group (group S), 14 patients in each group. Blood gas and circulating indicators (malondialdehyde, interleukin [IL]-6, and IL-8) were measured immediately before tourniquet inflation and at 0.5 hour, 2 hours, 6 hours, and 24 hours after tourniquet deflation.
  
  
  RESULTS
  Plasma levels of malondialdehyde, IL-6, and IL-8 in group C were significantly increased over baselines from 2 hours to 24 hours after tourniquet deflation and the levels reached their peaks at 6 hours after tourniquet deflation, when arterial partial pressures of oxygen and arterial-alveolar oxygen tension ratio were decreased, whereas alveolar-arterial oxygen difference was increased significantly. Both the changes in blood gas variables and plasma mediators were attenuated in group S.
  
  
  CONCLUSIONS
  Pulmonary gas exchange is impaired after lower limb ischemia-reperfusion induced by clinical tourniquet application. Pretreatment with SMI, a traditional Chinese medicine, attenuates lipid peroxidation and systemic inflammatory response and mitigates pulmonary dysfunction.
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou City, China.
authors.forename: Liangrong
authors.initials: L
authors.lastname: Wang
authors.forename: Wantie
authors.initials: W
authors.lastname: Wang
authors.forename: Xiyue
authors.initials: X
authors.lastname: Zhao
authors.forename: Lida
authors.initials: L
authors.lastname: Jin
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
authors.forename: Haixia
authors.initials: H
authors.lastname: Yao
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhuo
authors.forename: Lina
authors.initials: L
authors.lastname: Lin
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis; D001794:Blood Pressure; D004311:Double-Blind Method; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D015427:Reperfusion Injury / Q000517:prevention & control*; D014111:Tourniquets / Q000009:adverse effects
chemical_list: D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D015850:Interleukin-6; D016209:Interleukin-8; C009252:fructus schizandrae, radix ginseng, radix ophiopogonis drug combination; D008315:Malondialdehyde