Ischemic Preconditioning Attenuates Pulmonary Dysfunction After Unilateral Thigh Tourniquet–Induced Ischemia–Reperfusion

Lin, Lina; Wang, Liangrong; Wang, Wan-Tie; Jin, Long; Zhao, Xiangshan; Zheng, Liu-pu; Jin, LJ; Jiang, Lingzhi; Xiong, Xiaoxing

doi:10.1213/ane.0b013e3181e368d2

Cited by 46 publications

(55 citation statements)

References 31 publications

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“…The basic mechanism of remote IP is preparing one organ for ischemic insult by the application of IP to another site of the body (generally a lower limb) (16–18). Limb IP decreases the IR injuries in the lung, liver, myocardium and kidney and ameliorates the hemodynamic response to tourniquet application (19–27). These previous studies have shown that limb IP is a promising method for the prevention of IR-induced tissue injuries in certain clinical conditions.…”

Section: Introductionmentioning

confidence: 99%

Ischemic preconditioning attenuates lipid peroxidation and apoptosis in the cecal ligation and puncture model of sepsis

Olguner

Koca

Altekin

et al. 2013

Experimental and Therapeutic Medicine

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Sepsis and septic shock are are among the major causes of mortality in intensive care units. The lung and kidney are the organs most affected by sepsis. Evidence exists that lipid peroxidation and apoptosis may be responsible for the high mortality due to sepsis. Ischemic preconditioning (IP) is a method for the protection of tissues and organs against ischemia/reperfusion injury by reducing reactive oxygen species levels, lipid peroxidation and apoptosis. In the present study, the effects of IP were investigated in cecal ligation and puncture (CLP)-induced sepsis in rats. The three groups of animals used in the present controlled study were the sham-operated group (sham, n=7), which only underwent a laparotomy; the sepsis group (sepsis, n=7), which underwent cecal ligation and perforation; and the IP + sepsis group (IP+sepsis, n=7), which underwent CLP immediately prior to the application of three cycles of IP to the hind limb. The study was terminated at 6 h after the induction of CLP. Blood, kidney and lung tissue samples were collected for the determination of serum creatinine, blood urea nitrogen (BUN), neutrophil gelatinase-associated lipocalin (NGAL) and lung tissue malondialdehyde (MDA) levels, as well as histological examination. The serum creatinine, plasma NGAL and lung tissue MDA levels in the sepsis group were significantly increased compared with those in the sham and the IP+sepsis groups (P<0.05). Alveolar macrophage counts, histological kidney and lung injury scores, kidney (caspase 3) and lung tissue immuonreactivity (M30) scores in the sepsis group were also significantly increased compared with those in the sham and IP+sepsis groups (P<0.05). The alveolar macrophage count in the IP+sepsis group was increased compared with that in the sham group (P<0.05). In conclusion, IP inhibits lipid peroxidation and attenuates histological injury and apoptosis in the lung and kidney during sepsis.

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Section: Introductionmentioning

confidence: 99%

Ischemic preconditioning attenuates lipid peroxidation and apoptosis in the cecal ligation and puncture model of sepsis

Olguner

Koca

Altekin

et al. 2013

Experimental and Therapeutic Medicine

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“…One study used both anaesthetic and antioxidant intervention (propofol and N‐acetyl‐cysteine) (Table ). Three studies used ischaemic pre‐conditioning (Table ) and one study used both ischaemic pre‐conditioning and antioxidant intervention (N‐acetyl‐cysteine) (Table ).…”

Section: Resultsmentioning

confidence: 99%

Interventions to reduce tourniquet‐related ischaemic damage in orthopaedic surgery: a qualitative systematic review of randomised trials

et al. 2014

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SummaryIschaemia of the extremity from the use of a tourniquet and the subsequent reperfusion contribute to the release of reactive oxygen species. This release may result in injury to remote organs. We performed a qualitative systematic review exploring the interventions used to prevent tourniquet-related oxidative damage in adults undergoing orthopaedic surgery, and the possible relationship between biochemical oxidative stress markers and postoperative clinical outcomes. Seventeen randomised controlled studies were included in the qualitative synthesis. Most trials were of low methodological quality and only two studies reported postoperative clinical outcomes. Nine studies tested anaesthetics (propofol, dexmedetomidine, ketamine, and spinal anaesthesia); four studies tested antioxidants (N-acetylcysteine, vitamin C, and mannitol); and four studies tested ischaemic pre-conditioning. Fifteen studies showed a significant reduction in biochemical oxidative stress markers. We conclude that propofol and ischaemic preconditioning, in particular, appear to show some benefit at reducing oxidative stress following operations under tourniquet; the correlation between a reduction in oxidative stress and postoperative clinical outcomes should be further investigated in the future.

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“…Inflammatory mediators, such as interleukin-6, tumor necrosis factor, intracellular adhesion molecule, matrix metalloproteinase 9, and C-reactive protein, have been linked to DCI and are downregulated through preconditioning. [40][41][42][43][48][49][50][51][52][53][54] In addition, tissue is rendered more tolerant to ischemia through reduction of excitotoxicity and metabolic protection by enhancing mitochondrial function. Preconditioning also affects several other pathways that have been implicated in vasospasm and DCI.…”

Section: Preconditioning To Ameliorate Vasospasm and DCImentioning

confidence: 99%

Preconditioning the Human Brain

Koch

Gonzalez

2013

Stroke

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Ischemic Preconditioning Attenuates Pulmonary Dysfunction After Unilateral Thigh Tourniquet–Induced Ischemia–Reperfusion

Cited by 46 publications

References 31 publications

Ischemic preconditioning attenuates lipid peroxidation and apoptosis in the cecal ligation and puncture model of sepsis

Ischemic preconditioning attenuates lipid peroxidation and apoptosis in the cecal ligation and puncture model of sepsis

Interventions to reduce tourniquet‐related ischaemic damage in orthopaedic surgery: a qualitative systematic review of randomised trials

Preconditioning the Human Brain

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