Effect of different treatments for ischemia-reperfusion syndrome on the risk of adverse outcome of the disease

Zhigalova M. S., Kutetov D. E., Pasechnik I. N.

aims: to evaluate the influence of methods of treatment of the syndrome of ischemia-reperfusion (SIR) for the risk of adverse (fatal) outcome. Materials and methods: the study included 92 patients (85 men and 7 women) aged from 50 to 92 years (mean age of 68.4±3.5 years) with SIR, which arose after operations for critical limb ischemia (CLI). For 1-day stay in the intensive care unit and intensive therapy in all patients there was an increase in the level of key markers SIR: creatine phosphokinase (CPK) and myoglobin. Recorded uremia, decline in urine output <0.5 ml/kg/hour. Was diagnosed with clinical and laboratory signs of acute kidney injury (AKI). Results: it is established that on the background of conducting therapeutic plasma exchange (TPE) observed a statistically significant decrease in the concentrations of CPK and myoglobin. After the procedure hemodiafiltration (HDF) on-line recorded a statistically significant decrease in urea and creatinine, increase in the rate of diuresis. Conclusions: noted that the highest absolute risk of adverse outcome SIR in patients after surgery for CLI, was recorded in the treatment of patients with only conservative medical therapy, and the smallest in the application schema: TPE+HDF on-line.

Keywords:syndrome of ischemia-reperfusion injury, critical limb ischemia, acute kidney injury.