Related Experiment Videos
Mortality following lower limb ischemia-reperfusion: a systemic inflammatory response?
M M Yassin1, A A Barros D'Sa, G Parks
1Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K.
World Journal of Surgery
|October 1, 1996
Summary
Restoring blood flow to ischemic limbs increases mortality by damaging the gut. This leads to increased endotoxin and inflammation, suggesting gut-origin endotoxin triggers the systemic inflammatory response.
Area of Science:
- Physiology
- Pathology
- Surgical Complications
Background:
- Restoration of blood flow to ischemic lower limbs can paradoxically cause systemic complications and mortality.
- Lower limb ischemia-reperfusion injury is suspected to alter gut permeability, contributing to these systemic effects.
Purpose of the Study:
- To determine the effect of acute lower limb ischemia-reperfusion on mortality, bowel morphology, and circulating endotoxin and interleukin-6 concentrations in a rat model.
Main Methods:
- Adult Wistar rats were divided into control and ischemia-reperfusion groups.
- Bilateral hind limb ischemia was induced for 3 hours, followed by reperfusion in experimental groups.
- Mortality, small bowel morphology, plasma endotoxin, and interleukin-6 levels were assessed.
Main Results:
- Ischemia-reperfusion significantly increased mortality rate (70%) compared to controls (0%).
- Morphometric analysis revealed decreased small bowel mucosal thickness in the ischemia-reperfusion group.
- Plasma endotoxin and interleukin-6 concentrations were significantly elevated post-reperfusion.
Conclusions:
- Reperfusion of ischemic lower limbs causes structural gut changes and increased systemic endotoxin.
- Elevated endotoxin and pro-inflammatory cytokine activation suggest a gut-origin endotoxin-triggered systemic inflammatory response.
- This response may explain the mortality observed following reperfusion of acutely ischemic limbs.