BIOCHEMICAL AND HISTOPATHOLOGICAL CHANGES IN THE MORTALITY CAUSED BY ACUTE ISCHEMIC LIMB INJURY - A RABBITS MODEL

Restoration of blood flow to an acute ischemic extremity may deteriora te the ischemic injury, lead to multiple organ dysfunction or even dea th. This paradox of continuing injury during reperfusion is not comple tely understood, The role of multi-organ damage in the mortality cause d by ischemic limb injury is also still not clarified. The purpose of this study is to determine the biochemical and histopathological chang es in the mortality caused by ischemic limb injury. After anesthesia, the hindlimbs of 14 New Zealand white rabbits were made ischemic and s et into 8 hours or 12 hours of ischemia. Blood samples were obtained t hen the creatine kinase (CK) levels were determined and CK isoenzymes analyzed. All rabbits with 8 hours' ischemia survived well, and 5 of t he 7 rabbits with 12 hours' ischemia expired within 8 hours after repe rfusion. CK elevation was correlated most strongly with the time of th e ischemic insults. The percentage of CK-MB isoenzyme remained unchang ed after 8 hours' ischemia-reperfusion insult, while increased signifi cantly after 12 hours' ischemia-reperfusion insult. Histologic examina tions showed that the major systemic manifestation was massive destruc tion of the liver and kidney. The injuries are more obvious in areas w ith the greatest blood flow during reperfusion. We concluded that the ratio of CK-MB isoenzyme is most useful for distinguishing the risk of mortality caused by acute ischemic limb injury, and the cause of syst emic complications are attributed to the multi-organ failure.