Peripheral Vascular Surgery Society
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Peripheral Vascular Surgery Society |
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#28 DISTAL AORTIC PERFUSION AND THEOPHYLLINE IN THE AUGMENTATION OF POST ISCHEMIC RENAL BLOOD FLOW
Gwen M. Ayers, MD, Michael L. Miller, MD, & Stuart A. Harlin, MD
Keesler Medical Center Keesler AFB, MS Paper sponsored by Wm. Dennis Newton, MD
Purpose: This study was designed to determine the efficacy of pulsatile versus nonpulsatile perfusion in augmenting renal blood flow following renal artery ischemia. This study assessed the effect of theophylline on renal blood flow with either mode of distal perfusion.
Methods: A pig model was divided into six experimental groups encompassing a total of 50 pigs. Each group underwent cross-clamping of the suprarenal aorta for 60 minutes. The control group underwent cross-clamping of the suprarenal aorta without femoral cannulation and half of this group received theophylline. The remaining four groups underwent cross-clamping of the suprarenal aorta and were placed on pulsatile or nonpulsatile distal perfusion with or without theophylline. Theophylline dose was 2 mg/kg and administered 30 minutes prior to cross-clamping the suprarenal aorta. Renal blood flow was measured utilizing a flow probe placed on the renal artery and data was recorded for 20 minutes pre- and post-clamp. Alpha GST was used as a marker of renal ischemia.
Results: A total of 50 pigs were used in six groups. Post-clamp renal blood flow measurements were expressed as a percentage of pre-clamp renal blood flow. Post-clamp renal blood flow was standardized as a percent of pre-clamp renal blood flow. The pulsatile perfusion group (109%) had improved renal blood flow in comparison to the nonpulsatile perfusion group (88%) and both were superior to the control group (75%). The addition of theophylline improved renal blood flow in both distal perfusion groups. The nonpulsatile perfusion group improved post-clamp renal perfusion from 88 to 105%. The pulsatile perfusion group improved post-clamp renal perfusion from 109 to 120%. Alpha GST results indicated a decrease in renal ischemia with increased perfusion.
Conclusion: Pulsatile distal aortic perfusion is superior to nonpulsatile distal aortic perfusion in augmenting renal blood flow following renal artery ischemia in the pig model. Theophylline further augments renal blood flow following renal artery ischemia in the pig model.
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Last updated January 10, 1999