Motta Guilherme Lang, Souza Pablo Cambeses, Santos Emanuel Burck Dos, Bona Silvia Regina, Schaefer Pedro Guilherme, Lima Caetano Araújo Torres, Marroni Norma Anair Possa, Corso Carlos Otávio
Postgraduate Program in Medicine: Surgical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Postgraduate Program in Medicine: Surgical Sciences, UFRGS, Porto Alegre, RS, Brazil.
Acta Cir Bras. 2018 May;33(5):396-407. doi: 10.1590/s0102-865020180050000001.
To evaluate whether combining hypothermia and remote ischemic preconditioning (RIPC) results in protection from ischemia-reperfusion (IR).
Thirty-two Wistar rats underwent right nephrectomy and were randomly assigned to four experimental protocols on the left kidney: warm ischemia (group 1), cold ischemia (group 2), RIPC followed by warm ischemia (group 3), and RIPC followed by cold ischemia (group 4). After 240 minutes of reperfusion, histological changes in the left kidney, as well as lipid peroxidation and antioxidant enzyme activity, were analyzed. The right kidney was used as the control. Serum creatinine was collected before and after the procedures.
RIPC combined with hypothermia during IR experiments revealed no differences on interventional groups regarding histological changes (p=0.722). Oxidative stress showed no significant variations among the groups. Lower serum creatinine at the end of the procedure was seen in animals exposed to hypothermia (p<0.001).
Combination of RIPC and local hypothermia provides no renal protection in IR injury. Hypothermia preserves renal function during ischemic events. Furthermore, RIPC followed by warm IR did not show benefits compared to warm IR alone or controls in our experimental protocol.
评估低温与远程缺血预处理（RIPC）联合应用是否能对缺血再灌注（IR）起到保护作用。
32只Wistar大鼠接受右肾切除术，并将其左肾随机分为四种实验方案：热缺血（第1组）、冷缺血（第2组）、RIPC后热缺血（第3组）以及RIPC后冷缺血（第4组）。再灌注240分钟后，分析左肾的组织学变化以及脂质过氧化和抗氧化酶活性。右肾用作对照。在手术前后收集血清肌酐。
在IR实验期间，RIPC与低温联合应用在各干预组之间的组织学变化方面未显示出差异（p = 0.722）。氧化应激在各组之间无显著变化。在接受低温处理的动物中，手术结束时血清肌酐较低（p < 0.001）。
RIPC与局部低温联合应用在IR损伤中未提供肾脏保护。低温在缺血事件期间可保留肾功能。此外，在我们的实验方案中，与单独热IR或对照组相比，RIPC后热IR未显示出益处。
