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    Reperfusion Injury

    Uploaded by

    juju
    Reperfusion injury refers to cellular injury caused when blood flow and oxygen return to tissues after a period of ischemia or lack of oxygen. The restoration of blood flow and oxygen can paradoxically cause additional tissue damage through mechanical and biochemical mechanisms. These include free radical formation, inflammation, calcium overload, and apoptosis. Strategies to minimize reperfusion injury include slowly restoring perfusion to allow cells to rest, controlling breathing and circulation, and using drugs to reduce metabolic demand and inflammation. Understanding and mitigating reperfusion injury is important to improve patient outcomes after successful reperfusion.

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    Reperfusion Injury

    Uploaded by

    juju
    171 views11 pages
    Reperfusion injury refers to cellular injury caused when blood flow and oxygen return to tissues after a period of ischemia or lack of oxygen. The restoration of blood flow and oxygen can paradoxically cause additional tissue damage through mechanical and biochemical mechanisms. These include free radical formation, inflammation, calcium overload, and apoptosis. Strategies to minimize reperfusion injury include slowly restoring perfusion to allow cells to rest, controlling breathing and circulation, and using drugs to reduce metabolic demand and inflammation. Understanding and mitigating reperfusion injury is important to improve patient outcomes after successful reperfusion.

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    Reperfusion injury refers to cellular injury caused when blood flow and oxygen return to tissues after a period of ischemia or lack of oxygen. The restoration of blood flow and oxygen can paradoxically cause additional tissue damage through mechanical and biochemical mechanisms. These include free radical formation, inflammation, calcium overload, and apoptosis. Strategies to minimize reperfusion injury include slowly restoring perfusion to allow cells to rest, controlling breathing and circulation, and using drugs to reduce metabolic demand and inflammation. Understanding and mitigating reperfusion injury is important to improve patient outcomes after successful reperfusion.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    171 views11 pages

    Reperfusion Injury

    Uploaded by

    juju
    Reperfusion injury refers to cellular injury caused when blood flow and oxygen return to tissues after a period of ischemia or lack of oxygen. The restoration of blood flow and oxygen can paradoxically cause additional tissue damage through mechanical and biochemical mechanisms. These include free radical formation, inflammation, calcium overload, and apoptosis. Strategies to minimize reperfusion injury include slowly restoring perfusion to allow cells to rest, controlling breathing and circulation, and using drugs to reduce metabolic demand and inflammation. Understanding and mitigating reperfusion injury is important to improve patient outcomes after successful reperfusion.

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    Orthopaedi & Traumatologi

    Definition
    Reperfusion injury : cellular injury
    caused by the reperfusion of
    physiologic concentration of oxygen
    to cells that have been exposed to
    injurious but non lethal hypoxic
    condition1
    Other term : hiperperfusion injury, re-
    oxigenation injury
    BRAIN INJURY ISCHEMIA / HAEMORRHAGE
    STROKE
    GLOBAL ISCHEMIA

    TIME
    COLLATERAL
    SEVERITY OF STENOSIS
    ACUTE ISCHEMIA
    LEVEL OF ANTIOXIDANT
    NECROSIS/
    HYPOPERFUSION
    APOPTOSIS
    REPERFUSION
    GOING BETTER
    UNPREDICTABLE

    REPERFUSION INJURY

    MECHANICAL
    BIOCHEMICAL
    NECROSIS
    Etiology Of Reperfusion
    Injury
    I. Mechanicals II. CHEMICALS /
    Decompression: BIOMOLECULAR
    Post Operative 1. Platelet Activating Factor
    Recirculation: 2. Inflamation Reaction
    Thrombectomy 3. Neurotransmitters
    Thrombolytic Therapy 4. Growth Factor
    5. Cytokines
    6. Free Radicals
    7. Epinephirine

    NECROSIS
    Model Of Molecular Events During Brain Ischemia And
    Reperfusion That Lead to Neuronal Death

    ISCHEMIA ATP Depolarization Membrane Damage

    -calpain Cystosolic Ca2+ Phospholipase Lipid Peroxidation


    activation activation
    Fe2+
    Calcineurin NOS
    eIF4G & spectrin activation activation Peroxynitrite Free Arachidonate
    degradation ER Ca2+ Depletion O2
    REPERFUSION ATP Inhibited Growth
    eIF2 Factor Signaling
    kinaseactivation
    Epinephrine CHOP
    PP1 eIF2 (P) Bad
    PP2A Dephosphorylation,
    cAMP Inhibited Bad Mitochondria
    Inhibited Active Release cytochrome
    I1 activation Protein caspase 3 c
    PKA Synthesis & caspase 9 to
    activation APAF1
    Apoptosis
    Cells unable to respond to radical and proteolytic injury and DIE
    Reperfusion Injury

    Oxygen
    Blood
    restoratio Inflammatory factor
    n ( Interleukin, Free
    Radical,
    Ischem Leucocyte )
    Cell
    ia Small
    capillary
    endotheliu
    m

    Damage cellular
    protein
    DNA obstruction
    Plasma membrane
    Free
    radical
    Hypoperfusion
    Prolonged
    ischemia Hypoxantin
    ATP
    e Nitric oxide

    Xanthine Uric
    oxidase react acid
    scavenger
    Highly reactive
    Oxygen superoxide Peroxynitrite
    Hydroxyl radicals

    Lipid Peroxidation

    Membrane cell damage

    Apoptosis
    In some clinical situation, a substantial
    part of the ischemic injury may not have
    occurred during the period of ischemia
    but during the period of reperfusion.

    The secondary consequences of ischemia


    are those that occur after the cerebral
    circulation has been restored
    Mutimodal to minimize
    Reperfusion Injury Effect
    Airway secure the patency
    Breathing control and let the cell rest
    Circulation restore perfusion slowly
    Drugs Propofol, Penthotal, Midazolam, COX
    Inhibitor, Steroid

    Principle
    Reduce CMR O2
    Minimize Free radical and inflammatory factors production
    Summary
    Reperfusion injury is the hidden
    danger after successful perfusion
    restoration

    Reperfusion injury can be minimized

    Minimizing reperfusion injury can


    improve patients outcome
    Thank's

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