Clinical Consequences Of Ischemiareperfusion

The first clinical manifestations of ischemia-reperfusion syndromes are observed within the tissue or organ where the initial ischemia started. The ischemic insult, ensuing reperfusion and the secondary ischemia then aggravates the first lesion. This secondary ischemia is the result of different phenomena: the development of a compartment syndrome following edema formation; a reduction in blood flow due to arteriolar vasoconstriction; and capillary occlusion explained by endothelial cell alterations and intravascular thrombosis (platelet activation and release of proteases).

If the severity of the lesions provoked by the ischemia-reperfusion syndrome exceeds the metabolic capacity to deal with ischemia-reperfusion consequences (e.g. free radical scavenging potential), systemic manifestations develop that may ultimely be fatal. This is represented by hemodynamic shock, hyperkalemia, hypocalcemia, renal failure and ARDS.

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