caa a22 4500 47703604X CHVBK 20180405111305.0 cr unu---uuuuu 170330e19961001xx s 000 0 eng 10.1007/s002689900144 doi (NATIONALLICENCE)springer-10.1007/s002689900144 Mortality following Lower Limb Ischemia-Reperfusion: A Systemic Inflammatory Response? [Elektronische Daten] [Magdi M.I. Yassin, Aires A.B. Barros D'Sa, George Parks, Aminu S. Abdulkadir, Isla Halliday, Brian J. Rowlands] Abstract. Restoration of blood flow to an acutely ischemic lower limb may paradoxically result in systemic complications and unexpected mortality. It has been suggested that lower limb ischemia reperfusion alters gut permeability. In this study, using a rat model, we determined the effect of acute lower limb ischemia-reperfusion on mortality rate, bowel morphology, and circulating concentrations of endotoxin and the proinflammatory cytokine interleukin-6. Survival rate was compared in two groups of adult Wistar rats: (1) control group (: n = 10); and (2) animals subjected to 3 hours of bilateral hind limb ischemia followed by reperfusion ( n = 10). Both groups were observed under standard conditions for 4 days. In a second experiment three groups of animals were studied: (I) control ( n = 12); (II) 3 hours of bilateral hind limb ischemia alone ( n = 12); and (III) 3 hours of bilateral hind limb ischemia followed by 2 hours of reperfusion ( n = 12). Animals subjected to bilateral hind limb ischemia followed by reperfusion had a significantly higher mortality rate (70%) than controls (0%) ( p < 0.005). Morphometric assessment of the small bowel showed a significant decrease in mean mucosal thickness in the ischemia-reperfusion group compared with that in the group of controls and the ischemia-alone group ( p < 0.05). Bilateral hind limb ischemia followed by reperfusion was associated with significantly increased plasma concentrations of endotoxin ( p < 0.05) and interleukin-6 ( p < 0.0001) compared with that of controls and ischemia alone. These results indicate that reperfusion of the acutely ischemic lower limb is accompanied by structural changes in the gut mucosa associated with increased systemic endotoxin concentrations and cytokine activation. Mortality following reperfusion of the acutely ischemic limb may be related to a systemic inflammatory response triggered by endotoxin of gut origin. 1996 by the Société Internationale de Chir, ugie Yassin Magdi M.I. Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut Barros D'Sa Aires A.B. Vascular Surgery Unit, The Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut Parks George Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut Abdulkadir Aminu S. Department of Pathology, Institute of Clinical Science, The Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut Halliday Isla Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut Rowlands Brian J. Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut https://doi.org/10.1007/s002689900144 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900144 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yassin Magdi M.I. Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut NATIONALLICENCE 700 1- Barros D'Sa Aires A.B. Vascular Surgery Unit, The Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut NATIONALLICENCE 700 1- Parks George Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut NATIONALLICENCE 700 1- Abdulkadir Aminu S. Department of Pathology, Institute of Clinical Science, The Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut NATIONALLICENCE 700 1- Halliday Isla Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut NATIONALLICENCE 700 1- Rowlands Brian J. Department of Surgery, The Queen's University of Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, U.K., GB aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer