This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Diaphragmatic dysfunction secondary to experimental lower torso ischaemia–reperfusion injury is attenuated by thermal preconditioning. BJS 2000; 87: 201-205.
Published: 10th December 2002
Authors: R. McLaughlin, C. J. Kelly, E. Kay, D. Bouchier‐Hayes
Background
Preconditioning describes the process whereby tissue exposure to a subcritical stress confers protection from subsequent injuries. This study assessed diaphragmatic muscle function after lower torso ischaemia–reperfusion (IR) and the role of thermal preconditioning in attenuation of this injury.
Method
Sprague–Dawley rats were randomized into three groups (24 per group): a control group, an IR group that had aortic cross‐clamping for 1 h followed by reperfusion, and a third group that received thermal preconditioning 18 h before IR. Diaphragmatic function was assessed at 24 h, 48 h and 7 days.
Results
IR resulted in significant diaphragmatic twitch and tetanic dysfunction compared with control muscle. Thermal preconditioning significantly attenuated this injury (P < 0·05). Mean(s.e.m.) muscle twitch and tetanic forces in the IR group were 204·9(17·2) and 282·7(19·2) g respectively at 24 h. Corresponding twitch and tetanic forces in preconditioned muscle were 270·4(25·1) and 552·0(35·2) g.
Conclusion
This study demonstrated that systemic IR injury produced a respiratory muscle mechanical dysfunction that was attenuated by thermal preconditioning, at 24 h, 48 h and 7 days. Preconditioning may have a role in clinical practice, particularly before elective surgery. © 2000 British Journal of Surgery Society Ltd
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