Hepatosplanchnic Ischemia/Reperfusion is a Major Determinant of Lung Vascular Injury After Aortic Surgery

Cornet, Alexander D.; Kingma, Sytze; Trof, Ronald J.; Wisselink, Willem; Groeneveld, A. B. Johan

doi:10.1016/j.jss.2008.09.021

Cited by 12 publications

(5 citation statements)

References 36 publications

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“…LIRI is also a major source of morbidity and mortality after cardiac surgery, as it contributes to the development of ARDS, with an incidence of up to 20% and a mortality reaching 80% [45]. Interestingly, hepatosplanchnic IRI in aortic surgery has been found to cause lung injury, with increased pulmonary leak index (PLI) in up to 74% of the patients, especially in cases involving clamping of major aortic branches and in direct correlation with the aortic clamping time [46]. ALI also complicates 30-50% of major trauma cases, with an associated mortality of 10% depending on the severity of lung dysfunction [47].…”

Section: The Clinical Impact Of Lung Ischaemia Reperfusion Injurymentioning

confidence: 99%

The effects of ischaemic conditioning on lung ischaemia–reperfusion injury

et al. 2022

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Ischaemia–reperfusion injury (IRI) encompasses the deleterious effects on cellular function and survival that result from the restoration of organ perfusion. Despite their unique tolerance to ischaemia and hypoxia, afforded by their dual (pulmonary and bronchial) circulation as well as direct oxygen diffusion from the airways, lungs are particularly susceptible to IRI (LIRI). LIRI may be observed in a variety of clinical settings, including lung transplantation, lung resections, cardiopulmonary bypass during cardiac surgery, aortic cross-clamping for abdominal aortic aneurysm repair, as well as tourniquet application for orthopaedic operations. It is a diagnosis of exclusion, manifesting clinically as acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Ischaemic conditioning (IC) signifies the original paradigm of treating IRI. It entails the application of short, non-lethal ischemia and reperfusion manoeuvres to an organ, tissue, or arterial territory, which activates mechanisms that reduce IRI. Interestingly, there is accumulating experimental and preliminary clinical evidence that IC may ameliorate LIRI in various pathophysiological contexts. Considering the detrimental effects of LIRI, ranging from ALI following lung resections to primary graft dysfunction (PGD) after lung transplantation, the association of these entities with adverse outcomes, as well as the paucity of protective or therapeutic interventions, IC holds promise as a safe and effective strategy to protect the lung. This article aims to provide a narrative review of the existing experimental and clinical evidence regarding the effects of IC on LIRI and prompt further investigation to refine its clinical application.

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Section: The Clinical Impact Of Lung Ischaemia Reperfusion Injurymentioning

confidence: 99%

The effects of ischaemic conditioning on lung ischaemia–reperfusion injury

et al. 2022

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“…Під час оперативних утручань на низхідному відділі грудної аорти виникає ряд факторів, що ведуть до пошкодження комплексу легеневого сурфактанта, яке відіграє визначальну роль в патогенезі післяопераційної гострої дихальної недостатності (ГДН) [12]. Несприятливі наслідки для якісного та кількісного складу комплексу сурфактанта має тривале колабування лівої легені, що супроводжується ішемією та подальшої реперфузією [1].…”

Section: № 5(45) Vol2 May 2019unclassified

Зміна Стану Комплексу Легеневого Сурфактанту При Втручаннях З Приводу Гострого Аортального Синдрому В Умовах Штучного Кровообігу

Buchnieva¹

2019

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Objective. To study changes in the state of pulmonary surfactant complex during interventions in acute aortic syndrome. Materials and methods. Biochemical analysis and cytological study were conducted on 142 samples obtained during the bronchoalveolar lavage performed intraoperatively or in the early postoperative period. Results. It was determined that in the postoperative period the bronchoalveolar fluid of patients with disorders of gas exchange contained significantly more general protein, albumin and fibrinogen, indicating an increase in the alveolar membrane transport. The higher content of plasma proteins in the alveolar fluid of patients with ARDS was due to low phospholipid content, reflecting damage to the lung surfactant system. Conclusion. The obtained data indicates the damage of pulmonary surfactant complex followed by an increase in the alveolar membrane transport leading to development of acute respiratory distress syndrome after surgery on the aorta.

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“…However, the main consequences of temporary visceral aorta occlusion are related to the ischemia and reperfusion (I/R) injury of the splanchnic organs (3). Of the splanchnic organs, the intestine is the most sensitive to I/R injury and plays a pivotal role in the induction of systemic inflammation response syndrome (SIRS) and multiple organ dysfunction (MOD) (4,5), a major cause of morbidity in patients undergoing major aortic repair (6).…”

Section: Introductionmentioning

confidence: 99%

Local and remote ischemic preconditioning protect against intestinal ischemic/reperfusion injury after supraceliac aortic clamping

Erling

Montero

Sannomiya

et al. 2013

Clinics

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OBJECTIVES:This study tests the hypothesis that local or remote ischemic preconditioning may protect the intestinal mucosa against ischemia and reperfusion injuries resulting from temporary supraceliac aortic clamping.METHODS:Twenty-eight Wistar rats were divided into four groups: the sham surgery group, the supraceliac aortic occlusion group, the local ischemic preconditioning prior to supraceliac aortic occlusion group, and the remote ischemic preconditioning prior to supraceliac aortic occlusion group. Tissue samples from the small bowel were used for quantitative morphometric analysis of mucosal injury, and blood samples were collected for laboratory analyses.RESULTS:Supraceliac aortic occlusion decreased intestinal mucosal length by reducing villous height and elevated serum lactic dehydrogenase and lactate levels. Both local and remote ischemic preconditioning mitigated these histopathological and laboratory changes.CONCLUSIONS:Both local and remote ischemic preconditioning protect intestinal mucosa against ischemia and reperfusion injury following supraceliac aortic clamping.

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Hepatosplanchnic Ischemia/Reperfusion is a Major Determinant of Lung Vascular Injury After Aortic Surgery

Cited by 12 publications

References 36 publications

The effects of ischaemic conditioning on lung ischaemia–reperfusion injury

The effects of ischaemic conditioning on lung ischaemia–reperfusion injury

Зміна Стану Комплексу Легеневого Сурфактанту При Втручаннях З Приводу Гострого Аортального Синдрому В Умовах Штучного Кровообігу

Local and remote ischemic preconditioning protect against intestinal ischemic/reperfusion injury after supraceliac aortic clamping

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