BLOOD BIOCHEMICAL PARAMETERS CHANGES OF EXPERIMENTAL ANIMALS AS A RESULT OF COMBINED ABDOMINAL SKELETAL TRAUMA AND ISCHEMIA REPERFUSION OF THE LOWER EXTREMITIES
DOI:
https://doi.org/10.11603/mcch.2410-681X.2019.v.i4.10847Keywords:
ischemia, reperfusion, combined skeletal trauma, mineralization index, biochemical parametersAbstract
Introduction. Combined trauma is a major cause of death and long-term disability among working-age people. Osteoarthrosis is one of the most common complications. An unfavorable factor affecting the development of complication is ischemia – reperfusion of the limb, but its impact needs further study.
The aim of the study – to learn the effect of limb reperfusion in a model of combined abdominal-skeletal trauma and massive blood loss on changes in blood biochemical parameters.
Materials and Methods. The work was experimental and was performed on 130 adult white male Wistar rats. Animals were divided into four groups: control (CG) and three experimental (EG): control group; experimental group 1 (EG-1) – modeled a hip fracture, massive external bleeding, and ischemia-reperfusion of the lower extremities; experimental group 2 (EG -2) – modeled for skeletal trauma, massive external blood loss, and closed abdominal trauma; experimental group 3 (EG -3) – modeled closed abdominal trauma, skeletal trauma, massive external blood loss and ischemia-reperfusion of the lower extremities. The animals were removed from the experiment 3, 7, 14 and 21 days after trauma. The levels of alkaline phosphatase, acid phosphatase were determined in the serum of experimental animals and a mineralization index was calculated based on these data.
Results and Discussion. In experimental animals of all groups, a prolonged increase in the activity of alkaline and acid phosphatases and, as a consequence, the mineralization index were observed. Identified uniformity in the dynamics of changes in the studied parameters in rats of experimental groups 1 and 2. In the group of experimental animals that simulated abdomino-skeletal injury, massive blood loss and ischemia-reperfusion of the lower extremities, their changes were most pronounced, in particular, the mineralization index after 21 days was 51.7 % less than the control values (p<0.05).
Conclusion. Ischemia-reperfusion of the extremities with combined abdominal-skeletal injury adversely affects the reparative processes in bone tissue, as indicated by decrease in the index of mineralization.
References
Nance, M.L. (Ed.). (2013). National trauma data bank – annual report. NTDB Annual Report, American College of Surgeon.
Lefering, R., Paffrath, T., & Nienaber, U. (2013). Trauma Register DGU. Annual Report 2014. Sektion NIS of the German Trauma Society (DGU). Köln, Germany.
Banerjee, M., Bouillon, B., Shafizadeh, S., Paffrath, T., Lefering, R., & Wafaisade, A. (2013). Epidemiology of extremity injuries in multiple trauma patients. Injury, 44 (8), 1015-1021. DOI: https://doi.org/10.1016/j.injury.2012.12.007
Steel, J., Youssef, M., Pfeifer, R., Ramirez, J.M., Probst, C., Sellei, R., …, & Pape, H.C. (2010). Health-related quality of life in patients with multiple injuries and traumatic brain injury 10+ years postinjury. Journal of Trauma-Injury Infection & Critical Care, 69 (3), 523-530. DOI: https://doi.org/10.1097/TA.0b013e3181e90c24
Karladani, A., Granhed, H., Kärrholm, J., & Styf, J. (2001). The influence of fracture etiology and type on fracture healing: a review of 104 consecutive tibial shaft fractures. Arch Orthop Trauma Surg, 121 (6), 325-328. DOI: https://doi.org/10.1007/s004020000252
Tsunoda, M., Mizuno, K., & Matsubara, T. (1993). The osteogenic potential of fracture hematoma and its mechanism on bone formation – through fracture hematoma culture and transplantation of freeze-dried hematoma. Kobe Journal of Medical Sciences, 39 (1), 35-50.
Park, S.H., Silva, M., Bahk, W.J., McKellop, H., & Lieberman, J.R. (2002). Effect of repeated irrigation and debridement on fracture healing in an animal model. Journal of Orthopaedic Research, 20 (6), 1197-1204. DOI: https://doi.org/10.1016/S0736-0266(02)00072-4
Grundnes, O., & Reikeraas, O. (2000). Effects of macrophage activation on bone healing. Journal of Orthopaedic Science, 5 (3), 243-247. DOI: https://doi.org/10.1007/s007760050159
Bunn, R.J., Burke, G., Connelly, C., Li, G., & Marsh, D. (2005). Inflammation – a double edged sowrd in high-energy fractures? The Bone & Joint Journal, 87 (3), 265-266.
Thomas, A.C., Hubbard-Turner, T., Wikstrom, E.A., & Palmieri-Smith, R.M. (2017). Epidemiology of Posttraumatic Osteoarthritis. J. Athl. Train., 52 (6), 491-496. DOI: https://doi.org/10.4085/1062-6050-51.5.08
Johnson, V.L., & Hunter, D.J. (2014). The epidemiology of osteoarthritis. Best Pract. Res. Clin. Rheumatol., 28, 5-15. DOI: https://doi.org/10.1016/j.berh.2014.01.004
Volotovska, N.V., Nhokwara, T.C., & Zhulkevych, I.V. (2019). Changes in the glutathione systems activity of internal organs in the first hours of experimental limb ischemia-reperfusion syndrome, combined with blood loss and mechanical injury. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, 1, 23-27. DOI 10.11603/1811-2471.2019.v0.i1.10043
Kovalchuk, L.Ya., Hnatyiuk, M.S., Smiian, S.I., Zhulkevych, I.V., Masyk, O.M., Hudyma, A.A., & Lisnychuk, N.Ye. (2000). Kompleksne eksperymentalne doslidzhennia immobilizatsiinoi modeli osteoporozu [Complex experimental study of immobilization model of osteoporosis]. Visnyk naukovykh doslidzhen – Bulletin of Scientific Research, 1, 81-84 [in Ukrainian].
Smith, A.A., Ochoa, J.E., Wong, S., Beatty, S., Elder, J., Guidry, C., …, & Schroll, R. (2019). Prehospital tourniquet use in penetrating extremity trauma. Journal of Trauma and Acute Care Surgery, 86 (1), 43-51. DOI: https://doi.org/10.1097/TA.0000000000002095
Kauvar, D.S., Miller, D.M., & Walters, T.J. (2018). Tourniquet use is not associated with limb loss following military lower extremity arterial trauma. Journal of Trauma and Acute Care Surgery, 85 (3), 495-499. DOI: https://doi.org/10.1097/TA.0000000000002016
Vaynshteyn, S.G., Zhulkevich, I.V., Petropavlovskiy, G.A., & Kotelnikova, N.E. (1987). Zashchitnyye svoystva mikrokristallicheskoy tsellyulozy pri eksperimentalnom sakharnom diabete u krys [Protective properties of microcrystalline cellulose in experimental diabetes mellitus in rats]. Byull. eksperim. biol. i meditsiny – Bulletin of Experimental Biology and Medicine, 103, 2, 167-168 [in Russian].
Levitskiy, A.P., Makarenko, O.A., & Denga, O.V. (2005). Eksperimentalnyye metody issledovaniya stimulyatorov osteogeneza: Metod. rekomendatsii [Experimental methods for the study of stimulators of osteogenesis: Method. Recommendations]. Kyiv: GFTS [in Ukrainian].
Berezovskaya, O.P., & Lytovka, I.G. (2002). Osteogenez v usloviyakh gipokinezy i gipoksii [Osteogenesis in conditions of hypokinesia and hypoxia]. Problemy ekolohichnoi ta medychnoi henetyky i klinichnoi imunolohii. Zbirnyk naukovykh prats – Problems of Environmental and Medical Genetics and Clinical Immunology. Collection of Scientific Works, 6 (45), 19-31 [in Russian].