Hematological and hemostaseological alterations after warm and cold limb ischemia-reperfusion in a canine model

Acta Cirurgica Brasileira

Miklos Szokoly²  Norbert Nemeth¹  Istvan Furka¹  Iren Miko¹ 

[1],National Institute of TraumatologyBudapest

关键词: Ischemia;    Reperfusion;    Lower Extremity;    Cooling;    Blood Coagulation;    Hematology;    Dogs;    Isquemia;    Reperfusão;    Extremidade Inferior;    Esfriamento;    Coagulação Sanguínea;    Hematologia;    Cães;   

DOI  :  10.1590/S0102-86502009000500002

来源: SciELO

【 摘 要 】

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.

【 授权许可】

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