Controlled reperfusion reduces hemorheological alterations in a porcine infrarenal aortic-clamping ischemia-reperfusion model.
BACKGROUND
Restoration of blood flow after prolonged acute ischemia causes further injury to tissues. The role of increased oxidative stress is emphasized in the pathogenesis, and impairment of hemorheological factors may also hinder proper microcirculation. Controlled reperfusion at lowered pressure with diluted blood may help to decrease reperfusion injury.


METHODS
Four-hour infrarenal aortic clamping was performed in 16 Yorkshire pigs. In 8 animals blood flow was restored subsequently (full reperfusion, FR), in the other 8 animals clamping was followed by an initial 30 minutes of controlled reperfusion (CR) at 60 mmHg pressure with a 1 : 1 ratio mixture of blood and reperfusion solution. Blood samples were taken before the intervention, at the end of ischemia, 15 minutes, 60 minutes, 1 day and 1 week after the start of reperfusion. Hemorheological parameters were measured.


RESULTS
Hematocrit, plasma and whole blood viscosity decreased significantly during CR, these attenuated at 1 day. At 1 week whole blood and plasma viscosities were elevated in the FR group. Erythrocyte deformability did not change significantly at any measurements. Erythrocyte aggregation decreased during CR but not in FR, and was found elevated in both groups at 1 week.


CONCLUSIONS
Our results suggest slightly improved hemorheological properties in case of controlled reperfusion compared to full reperfusion, which may help to reduce tissue damage.
1st Department of Medicine, University of Pecs, Pecs, Hungary.
P
P
Kenyeres
Department of Vascular Surgery, University of Pecs, Pecs, Hungary.
L
L
Sinay
Department of Vascular Surgery, University of Pecs, Pecs, Hungary.
G
G
Jancso
1st Department of Medicine, University of Pecs, Pecs, Hungary.
M
M
Rabai
1st Department of Medicine, University of Pecs, Pecs, Hungary.|Department of Radiology, University of Pecs, Pecs, Hungary.
A
A
Toth
1st Department of Medicine, University of Pecs, Pecs, Hungary.
K
K
Toth
Department of Vascular Surgery, University of Pecs, Pecs, Hungary.
E
E
Arato
D000818:Animals; D001012:Aorta, Abdominal / Q000473:pathology*; D006439:Hemodynamics; D018056:Hemorheology; D007511:Ischemia / Q000503:physiopathology*; D008833:Microcirculation; D018384:Oxidative Stress; D015424:Reperfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000097:blood* / Q000473:pathology; D013552:Swine
Reperfusion injury; controlled reperfusion; hemorheological parameters