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Acute pulmonary injury in a model of ruptured abdominal aortic aneurysm.

Abstract：

PURPOSE:The purpose of this study was to determine whether the combined insults of hemorrhagic shock and aortic clamping simulating ruptured abdominal aortic aneurysm repair had a synergistic effect on the production of pulmonary injury, indicating remote organ injury. METHODS:Animals were randomized to one of three groups, infrarenal clamp plus 1 hour of shock, infrarenal clamp plus 2 hours of shock, and supramesenteric clamp plus 1 hour of shock. Each of these groups had four subgroups; sham, shock (mean arterial pressure of 50 mm Hg), clamp, or combined [shock plus clamp]). All animals had a laparotomy with aortic clamping in only the clamp and combined groups. Five hours after clamp removal lung permeability index and neutrophil sequestration were quantified. RESULTS:Lung permeability index (6.60 +/- 0.63, p < 0.05 vs all other groups) and neutrophil sequestration (3.72 +/- 0.45 vs sham and clamp, p < 0.05) were significantly increased when shock and supramesenteric clamp were combined. After 1 or 2 hours of shock and infrarenal clamping, no increase in lung permeability index was noted, although neutrophil sequestration was increased in the 2-hour shock group. CONCLUSIONS:These results demonstrate the additive effect of shock and supramesenteric clamping, which initiated a cascade of injurious events that resulted in a rapid pulmonary injury. The high mortality rate related to remote organ failure in ruptured abdominal aortic aneurysm may be related to the synergy of these two injurious processes.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Lindsay TF,Walker PM,Romaschin A

doi

10.1016/s0741-5214(95)70081-1

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

1-8

issue

1

eissn

0741-5214

issn

1097-6809

pii

S0741521495001352

journal_volume

22

pub_type

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