J.Jpn. Surg. Soc.. 87(8): 889-899, 1986

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Original article

METHODS OF SUPPRESSION OF MYONEPHROPATHIC METABOLIC SYNDROME AFTER INFRA-RENAL AORTIC OCCLUSION

Acute arterial occlusion of the extremities may result in severe and complex metabolic derangement. In order to evaluate the development and means of therapeutic control of metabolic derangements following the acute arterial occlusion of extremities,32 adult mongrel dogs weighing between 7 and 15kg underwent acute arterial occlusion by cross-clamping the infrarenal aorta. The experimental animals were divided into two groups: (1) an untreated group, and (2) treated group. The former was divided into three groups－12, 24 and 48 hour's arterial occlusive groups and the latter into two groups with 48 hour's arterial occlusion－tris (hydroxymethyl) aminomethane (THAM) and perfusion groups.
Biochemical and electrolyte analyses were measured before occlusion, immediately before, and 1,3, 12, 24 and 48 hours after the release of the occlusion.
The SGOT, CPK, aldolase, creatinine and blood urea nitrogen Ievels rose after the release of the occlusion and were significantly higher in the 48 hour's group than in the 12 and 24 hour's occlusive groups. Among these enzymatic changes, the creatinine and urea nitrogen levels were high 48 hours after the release of the occlusion, though the others decreased with time after the occlusion release. The blood pH level fell after the occlusion in the untreated groups and these levels increased slowly after the release of the occlusion. However, there were no significant differences in the blood pH among the untreated groups. The acute arterial occlusion by cross-clamping the infra-renal aorta caused severe renal damage among the various organs.
In the groups treated with THAM and perfusion, the SGOT, CPK, aldolase, creatinine and blood urea nitrogen levels remained almost at preocclusion levels after the release of the occlusion. There were statistically significant differences in these enzymatic changes between the treated group and the 48 hour's occlusive group without treatment. The blood pH levels in the treated groups showed minimal changes after the release of the occlusive, although there were no significant differences in the blood pH between the treated groups and the 48 hour's occlusive group without treatment.
It was concluded that the intravenous administration of THAM and peripheral washing were effective against untoward metabolic changes occurring in the ischemic extremities.

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