Hemodynamic Changes Secondary to Aortic Occlusion and Shock Are Not Mediated by Oxygen Free Radicals

Abstract

Since the ischemia/reperfusion syndrome may be associated with generation of oxygen free radicals (OFR), this study was designed to evaluate the effects of OFR inhibitors (allopurinol, superoxide dismutase) on the hemodynamic pa rameters associated with aortic clamping and shock. Normotensive animals showed minimal hemodynamic changes following a two-hour clamping and declamping of the aorta. Hypotensive occlusion was, however, associated with significant myocardial depression one hour after clamping in control and treated animals. No other major hemodynamic changes were noted between various groups at various phases of the experiment. The authors conclude that (1) myocardial depression occurs mainly with hypotensive occlusion and (2) OFR are not involved in these hemodynamic changes. The latter may be related to myocardial dysfunction secondary to hy povolemia. 1. Campbell GS: Physiological and technical factors in the surgical treatment of abdominal aortic aneurysms. Surgery 62:789-793, 1967. 2. Perry MC: The hemodynamics of temporary abdomi nal aortic occlusion. Ann Surgery 168:193-200, 1968. 3. Strandness DE, Parrish DG, Bell JW: Mechanism of declamping shock in operations on the abdominal aorta. Surgery 50:488-492, 1961. 4. Utsonomiya T, Krausz MM, Dunham B, et al: Mainte nance of cardiodynamics with aspirin during abdomi nal aortic aneurysmectomy. Ann Surg 194:602-608, 1981. 5. Stewart TR, Crute SL, Laughlin V, et al: Allopurinol prevents free radicals mediated myocardial reperfusion injury. Surg Forum 34:325-327, 1983. 6. DeWall RA, Vasco KA, Stanley EL, et al: Responses of the ischemic myocardium to allopurinol. Am Heart J 82:362, 1971. 7. Jaworek D, Gruber W, Bermeyer HU: ADP and AMP. In: Methods of Enzymatic Analysis, ed. by Bergmeyer HU. New York, Academic Press, 1974, pp. 2127- 2131. 8. Lamprecht W, Trautschold A: ATP: Determination with hexokinase and GGPD. In: Methods of Enzy matic Analysis, ed. by Bergmeyer HU. New York, Ac ademic Press, 1974, pp. 2101-2109. 9. Shatney CH, Toledo Pareya LH, Lillerei RC: Experi ence with allopurinol in canine endotoxic shock. Adr Shock Res 4:119-137, 1980. 10. Granger DN, Rutili G, McCord GM: Superoxide radi cals in feline intestinal ischemia. Gastroenterology 81:22-29, 1981. 11. Attia RR, Murphy JD, Snider M, et al: Myocardial ischemia due to infraaortic cross clamping during aor tic surgery in patients with severe coronary artery dis ease. Circulation 53:961-965, 1976. 12. Caroll RM, Lavaruso RR, Schauble JF: Left ventricu lar function during aortic surgery. Arch Surg 11:740- 743, 1976. 13. Silverstein PR, Caldera DL, Cullen DJ, et al: Avoiding the hemodynamic consequences of aortic cross clamp ing and unclamping. Anesthesiology 50:462-466, 1979. 14. Dunn E, Prager RL, Fry W, Kirsh MM: The effect of aortic cross clamping on myocardial function. J Surg Res 22:463-468, 1977. 15. Bush HL, LoGerfo FW, Weisel RD, et al: Assessment of myocardial performance and optimal volume load ing during elective abdominal aneurysm resection. Arch Surg 112:1301-1305, 1977. 16. Reiz S, Peter T, Rais O: Hemodynamic and cardiome tabolic effects of intrarenal aortic and common iliac artery declamping in man. An approach to optimal vol ume loading. Acta Anesth Scand 23:579-586, 1979. 17. Haljamac H, Enger E: Human skeletal muscle energy metabolism during and after complete tourniquet ische mia. Ann Surg 182:9-14, 1975. 18. Larsson J, Hultman E: The effect of long term arterial occlusion on energy metabolism of the human quadri ceps muscle. Scand J Clin Lab Invest 39:257-264, 1979. 19. Anderson J, Eklolf R, Thomson D: Metabolic changes in blood and skeletal muscle in reconstructive aortic surgery. Ann Surg 189:283-289, 1979. 20. Eklof B, Neglen P, Thomson D: Temporary incomplete ischemia of the legs induced by aortic clamping in man. Ann Surg 193:89-98, 1981. 21. Todd GT, Askanazi T, Rodrigues JL: Muscle high en ergy phosphates after lower extremity revasculariza tion. Surg Forum 34:464-465, 1983. 22. Gross GM, Berkowitz HD, Chance B, Marris JM: Measurement of muscle metabolism and high energy phosphates in arterial occlusive disease using P31 nu clear magnetic resonance. Surg Forum 35:442-444, 1984. 23. McCord JM, Fridorich I: The biology and pathology of oxygen radicals. Ann Int Med 89:122-127, 1978. 24. Crowell JW, Jones CE, Smith EE: Effect of allopurinol on hemorrhagic shock. Am J Physiol 216:744, 1969.