The measurement of red blood cell deformability provides a possible method for detecting the effect of ischemia-reperfusion on erythrocytes. In our study the effect of 1-h ischemia-reperfusion with or without allopurinol pretreatment on hematological parameters and red blood cell deformability was investigated in a follow-up experiment of 26 male CD outbred rats that were subjected to unilateral hind-limb ischemia by microvascular clips on femoral vessels for 1 h (IR, n = 6), some rats received allopurinol pretreatment under the same conditions (50 mg/kg, AP + IR, n = 8), others were subjected to sham operation (n = 6), and the rest of animals served as control (n = 6). Measurement of erythrocyte deformability using a bulk filtrometer with special setting of cell suspension hematocrit (1%), and determination of hematological parameters were performed daily for one week. In the IR group, relative cell transit time increased significantly on postoperative days 1 and 2, which was not observed in the other groups. Settings for the measurement of erythrocyte deformability by reducing the blood sample volume gave the possibility of monitoring the resulting changes in rats. Mean corpuscular volume and hemoglobin, platelet count, and platelet volume were higher in the IR and AP + IR groups than in the other groups. In summary, short-term ischemia and reperfusion induced lower red blood cell deformability in the early postoperative period, which could be prevented by allopurinol pretreatment.

We investigated the systemic hemodynamic effects and the early arteriovenous acid-base changes after 2-h tourniquet ischemia on left hind limb in rats during the first hour of reperfusion. The right femoral artery and vein were prepared and catheterized for direct blood pressure monitoring and blood sampling. In ischemia-reperfusion group, 5 min before releasing the tourniquet and during the first hour of the reperfusion (5', 10', 15', 30', 45', and 60'), arterial and venous blood samples were taken in parallel with a sham operated control group. In the ischemia-reperfusion group venous pH continuously decreased during reperfusion and was significantly lower compared to control and base in the 60th min, while arterial pH remained almost unchanged. PCO2 and pO2 showed moderate signs of a parallel respiratory compensation. Mean arterial pressure decreased almost by 20%, heart rate slightly increased during reperfusion. Our data indicates that besides the general effects anesthesia, limb ischemia-reperfusion results in hemodynamic and acid-base changes during the first hour of reperfusion.

PURPOSE: 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. CONCLUSION: 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.

Typical mechanisms and specifi c injuries of people involved in road traffi c accidents are presented. Injury patterns specifi c to occupants of vehicles with enclosed passenger compartment, as well as unprotected participants of traffi c (pedestrians, bicyclists, motorcyclists, etc.) are grouped. Injury severity classifi cation, treatment planning and outcome prediction is usually done based on various scoring systems, both internationally and in Hungary. The enormous number of such scoring systems make a thorough survey diffi cult and conversion among these scores has limitations. However prehospital care providers and hospital emergency staff need a "common language", preferably a system that utilizes the advantages of scoring systems. There is no uniform practice of this communication and data transfer in Hungary now, that is why part of the important data from the incident scene might not get to the hospital together with the patient. The documentation of prehospital care providers both in Hungary and abroad are discussed and analyzed. Score systems in prehospital and emergency medicine, as well as outcome prediction measures are covered. Data collection schemes especially the Utstein-Style for documenting major trauma and the German MIND2 (Minimale Notarztdatensatz, minimal prehospital care data set) are also presented. A suggestion is introduced for the data content of prehospital documentation, so that it could further help hospital admission and care. The main aspects of the suggestion are road traffi c accidents, because the creation of such a widely accepted and used document (a prehospital patient report form) requires a team of experts from various-mainly medical-specialties. Technical aspects, such as digital data collection are also covered. Future directions of development are named, too.