THE EFFECT OF MANNITOL ON REPERFUSION INJURY AND POSTISCHEMIC COMPARTMENT PRESSURE IN SKELETAL-MUSCLE

被引：22

作者：

OREDSSON, S

PLATE, G

QVARFORDT, P

机构：

[1] Department of Surgery, Helsingborg Hospital, University of Lund

来源：

EUROPEAN JOURNAL OF VASCULAR SURGERY | 1994年 / 8卷 / 03期

关键词：

ISCHEMIA; REPERFUSION INJURY; SCAVENGERS; MANNITOL; COMPARTMENT SYNDROME;

D O I：

10.1016/S0950-821X(05)80150-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Mannitol has previously been shown to reduce skeletal muscle reperfusion injury and postischaemic compartment pressure. The present study was designed to evaluate whether these effects result from hyperosmolarity or free radical scavenging. A rabbit hindlimb perfusion model was used to compare the effects of mannitol (n = 6), glucose (n = 6)-an isomer of mannitol without scavenging effect-and fasciotomy (n = 6) on oedema, compartment pressure, energy charge, and muscle injury after 4 hours of ischaemia and 2 hours of reperfusion. One limb from each animal received treatment, while the other limb served as an untreated control. Mannitol and glucose reduced (p < 0.05) muscle water content and decreased (p < 0.01) the compartment pressure. Fasciotomy had no effect on muscle water content but normalised compartment pressure. The increase in energy charge following reperfusion was improved (p < 0.05) and uptake of [Tc99]methylenediphosphonate-an indicator of muscle injury-was reduced (p < 0.05) by mannitol only. In conclusion, mannitol reduces postischaemic oedema mainly by its hyperosmolar property whereas restitution of energy production and reduction of muscle necrosis seem to be an effect of free radical scavenging. The compartment pressure is reduced by hyperosmolarity and free radical scavenging. © 1994 W. B. Saunders Company Ltd.

引用

页码：326 / 331

页数：6

共 32 条

[1]

Haimovici, Metabolic complications of acute arterial occlusions, J Cardiovasc Surg, 20, pp. 349-357, (1979)

[2]

Korthuis, Granger, Townsley, Taylor, The role of oxygen-derived free radicals in ischaemia-induced increases in canine skeletal muscle vascular permeability, Circ Res, 57, pp. 599-609, (1985)

[3]

Persson, Takolander, Bergqvist, Lower limb oedema after arterial reconstructive surgery. Influence of preoperative ischaemia, type of reconstruction and postoperative outcome, Acta Chir Scand, 155, pp. 259-266, (1989)

[4]

Hargens, Schmidt, Evans, Gonsales, Cologne, Garfin, Mubarak, Hagan, Akeson, Quantitation of skeletal-muscle necrosis in a model compartment syndrome, J Bone Joint Surg, 63 A, pp. 631-636, (1981)

[5]

Qvarfordt, Christenson, Eklof, Ohlin, Intramuscular pressure after revascularization of the popliteal artery in severe ischaemia, Br J Surg, 70, pp. 539-541, (1983)

[6]

Blebea, Kerr, Hobson, Padberg, The effects of oxygen free radical scavengers on skeletal muscle ischemia and reperfusion injury, Curr Surg, pp. 396-398, (1987)

[7]

Oredsson, Plate, Qvarfordt, Allopurinol-a free radical scavenger—reduces reperfusion injury in skeletal muscle, Eur J Vasc Surg, 5, pp. 47-52, (1991)

[8]

Walker, Lindsay, Labbe, Mickle, Romaschin, Salvage of skeletal muscle with free radical scavengers, J Vasc Surg, 5, pp. 68-75, (1987)

[9]

Delmaestro, Thaw, Bjork, Planker, Arfors, Free radicals as mediators of tissue injury, Acta Physiol Scand, 492, pp. 43-57, (1980)

[10]

Jepson, ISCHÆMIC CONTRACTURE, Annals of Surgery, 84, (1926)

← 1 2 3 4 →