Therapeutic option for managing lung injury induced by infrarenal aortic cross-clamping

Background: Operations on the infrarenal aorta can cause ischemic-reperfusion (IR) injury in local tissues, which could result in remote organ (e.g., lung) damage. Treatment of such injuries remains an unresolved problem. Objectives: Our aim was to reduce remote lung damage after lower limb IR by means of postconditioning. Materials and methods: Male Wistar rats were divided into three groups: Sham-operated, IR, and Postconditioned (PostC). In the latter two groups rats underwent 180 min of exclusion of the infrarenal aorta. The reperfusion time was 4 h. Serum-free radical levels, tumor necrosis factor-alpha and interleukin-6 concentrations, histologic changes in the lung, wet/dry-ratio, myeloperoxidase activity, heat shock protein 72 level and blood gas changes were investigated. Results: Postconditioning reduced histological damage in the lung (P < 0.05). Free radical levels and tumor necrosis factor-alpha concentrations were significantly lower in the PostC group than in the IR group (P < 0.05 and P < 0.01, respectively). Interleukin-6 concentrations did not significantly differ in the PostC group. Compared with the IR group, lung myeloperoxidase activity was lower in the PostC group. Decreased pulmonary heat shock protein 72 level was observed in the PostC group compared with the IR group and the wet/dry-ratio was also significantly lower in the PostC group (P < 0.05). A noticeably higher arterial pO(2) level was manifest in the PostC group after 2 and 4 h of reperfusion (P < 0.05). Conclusions: Postconditioning reduced lung damage under experimental conditions, in the early period of reperfusion after lower limb IR injury. (C) 2013 Elsevier Inc. All rights reserved.