Study of morphological changes in the kidney during modeling of ischemic-reperfusion injuries of the limb and massive blood loss

  • N. V. Volotovska I. Ya. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Keywords: hemostatic tourniquet, kidney, experiment, ischemic-reperfusion syndrome, blood loss).


The article presents the features of morphological disorders of liver tissue on the background of limb ischemia-reperfusion and massive blood loss. The aim of the work was to establish the presence of structural changes and the severity of morphological disorders of internal organs, remote from the primary place of ischemia-reperfusion during modeling the pathological process. The experiment was performed on 33 adult nonlinear white rats weighing 200-250 g, which were on the standard vivarium diet. Experimental animals were simulated with ischemic-reperfusion syndrome of the lower extremity and massive blood loss. Collection of materials was performed 1 h after intervention or release from the tourniquet and on the 1st, 3rd, 7th and 14th days. All interventions were performed under thiopental-sodium anesthesia (40 mg/kg body weight). Mostly structural violations were expressed as disturbance of blood supply of little and middle caliber blood vessels and also in initial dystrophic changes. During comparison of groups, depending on the severity, it was shown that both the isolated use of a tourniquet and massive blood loss had long-term, systemic consequences, however, more expressed in EG-2; single vascular glomeruli were shrunked, endothelial cells of arterioles were slightly damaged. On the 7th and 14th days changes in the structure of EG-1 were mostly absent, although in EG-2 the epitheliocytes of the outer layer of the capsule remained flattened, retained full blood vessels of the venous bed in the interstitium, and the vast majority of epitheliocytes of the excretory tubules were at different stages of hydropic dystrophy with partly desquamation of the epithelium in the gaps of the tubules. Also, the basal membranes of the tubules were not completely visualized, which indicates deep damage in the structures caused by acute ischemia as a result of bleeding. Thus, as combat trauma (blood loss) is in itself a life-threatening factor, the use of a tourniquet due to the development of ischemic-reperfusion process can complicate the course of the primary affection. Knowledge of the periodization of traumatic disease on the background of this pathology is important for the development of sanogenic effects in order to minimize this pathogenic factor.


[1] Ardasheva, E. I., Razumov, P. S., & Dolgova, S. G. (2004). Влияние перфторана на процессы перекисного окисления липидов в головном мозге и мягких тканях крыс при тяжелой компрессионной травме [Effect of perfluorane on lipid peroxidation processes in the brain and soft tissues of rats with severe compression injury]. Биомедицинский журнал – Biomedical Journal, (5), 151-153.
[2] Bitencourt, C. S., Bessi, V. L., Huynh, D. N., Ménard, L., Lefebvre, J. S., Lévesque, T., ... & Marleau, S. (2013). Cooperative role of endogenous leucotrienes and platelet‐activating factor in ischaemia–reperfusion‐mediated tissue injury. Journal of cellular and molecular medicine, 17(12), 1554-1565. doi: 10.1111/jcmm.12118
[3] Blaisdell, F. W. (2002). The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome: a review. Cardiovascular Surgery, 10(6), 620-630. doi: 10.1016/s0967-2109(02)00070-4
[4] Burianov, O. A., Strafun, S. S., Laksha, A. M., Yarmoliuk, Yu. O., Mazevych, V. B., & Lykhodii, V. V. (2014). Вогнепальні поранення кінцівок: Методичні рекомендації [Gunshot wounds of the extremities: Methodical recommendations]. К., 2014.
[5] De Groot, H., & Rauen, U. (2007). Ischemia-Reperfusion Injury: Processes in Pathogenetic Networks: A Review. In Transplantation proceedings (Vol. 39, No. 2, pp. 481-484). Elsevier. doi: 10.1016/j.transproceed.2006.12.012
[6] Ergün, Y, Üremiş, M., Kılınç, M., & Alıcı T. (2016). Antioxidant effect of Legalon(r) SIL in ischemia-reperfusion injury of rat skeletal muscle. Acta Cirúrgica Brasileirа, 31(4), 264-270. doi: 10.1590/S0102-865020160040000007
[7] Ferrari, R. S., & Andrade, S. F. (2015). Oxidative Stress and Lung Ischemia-Reperfusion Injury. Oxidative Medicine and Cellular Longevity, 2015. doi: 10.1155/2015/590987
[8] Gillani, S., Cao, J., Suzuki, T., & Hak, D. J. (2012). The effect of ischemia reperfusion injury on skeletal muscle. Injury, 43(6), 670-675. doi: 10.1016/j.injury.2011.03.008
[9] Henyk, S. M., & Symchych, A. V. (2016). Реперфузійний синдром після реваскуляризації ішемії нижніх кінцівок [Reperfusion syndrome after revascularization of lower extremity ischemia]. Серце і судини – Heart and blood vessels, (3), 104-108.
[10] Howell, N. J., & Tennant, D. А. (2014). The role of HIFs in ischemia-reperfusion injury. Hypoxia, (2), 107-111. doi: 10.2147/HP.S49720
[11] Inaba, K., Siboni, S., Resnick, S., Zhu, J., Wong, M. D., Haltmeier, T., ... & Demetriades, D. (2015). Tourniquet use for civilian extremity trauma. Journal of Trauma and Acute Care Surgery, 79(2), 232-237. doi: 10.1097/TA.0000000000000747
[12] Kauvar, D. S., Baer, D. G., Dubick, M. A., & Walters, T. J. (2006). Effect of fluid resuscitation on acute skeletal muscle ischemia-reperfusion injury after hemorrhagic shock in rats. Journal of the American College of Surgeons, 202(6), 888-896. doi: 10.1016/j.jamcollsurg.2006.03.003
[13] Kauvar, D. S., Dubick, M. A., Walters, T. J., & Kragh Jr, J. F. (2018). Systematic review of prehospital tourniquet use in civilian limb trauma. Journal of trauma and acute care surgery, 84(5), 819-825. doi: 10.1097/TA.0000000000001826
[14] Kryliuk, V. O., & Hariian, S. V. (2019). Вплив ішемії-реперфузії на морфологічні зміни великих суглобів нижніх кінцівок за умов поєднаної абдоміно-скелетної травми [Influence of ischemia-reperfusion on morphological changes of large joints of the lower extremities under the conditions of combined abdominal and skeletal trauma]. Eкспериментальна і клінічна медицина – Experimental and clinical medicine, 85(4), 4-8. doi: 10.35339/ekm.2019.85.04.01
[15] Kutepov, D. E., Zhigalova, M. S., & Pasechnik, I. N. (2018). Патогенез синдрома ишемии-реперфузии [Pathogenesis of ischemia-reperfusion syndrome]. Казанский медицинский журнал – Kazan Medical Journal, 99(4), 640-644. doi: 10.17816/KMJ2018-640
[16] Laubach, V. E., & Sharma, A. K. (2016). Mechanisms of lung ischemia-reperfusion injury. Current opinion in organ transplantation, 21(3), 246. doi: 10.1097/MOT.0000000000000304
[17] Leurcharusmee, P., Sawaddiruk, P., Punjasawadwong, Y., Chattipakorn, N., & Chattipakorn, S. C. (2018). The Possible Pathophysiological Outcomes and Mechanisms of Tourniquet-Induced Ischemia-Reperfusion Injury during Total Knee Arthroplasty. Oxidative Medicine and Cellular Longevity, 2018. doi: 10.1155/2018/8087598
[18] Pedowitz, R. A. (1991). Tourniquet-induced neuromuscular injury. A recent review of rabbit and clinical experiments. Acta Orthopaedica Scandinavica, 62(sup245), 1-33. PMID: 1950503
[19] Sergiyenko, V. I., Petrosyan, E. A., Onopriyev, V. I., & Laypanov, Kh. Kh. (2006). Морфологические изменения легких при моделировании и лечении ишемических и реперфузионных повреждений конечности [Morphological changes in the lungs during modeling and treatment of ischemic and reperfusion injuries of the limb]. Общая реаниматология – General resuscitation, 2(5-6), 129-132.
[20] Sheiko, V. D., Panasenko, S. I., & Chelishvili, A. L. (2019). Хірургія надзвичайних ситуацій – навчальний посібник [Emergency surgery – a textbook]. Полтава: Астрая, 2019 – Poltava: Astraya, 2019.
[21] Teoh, N. C., & Farrell, G. C. (2003). Hepatic ischemia reperfusion injury: Pathogenic mechanisms and basis for hepatoprotection. Journal of Gastroenterology and Hepatology, 18(8), 891-902. doi: 10.1046/j.1440-1746.2003.03056.x
[22] Walters, T. J., Gang, K., & Corona, B. T. (2015). Activity attenuates skeletal muscle fiber demage after ischemia and reperfusion. Muscle Nerve, 52(4), 640-648. doi: 10.1002/mus.24581
[23] Whatling, P. J., & Galland, R. B. (1999). Isolated Compartment Syndrome of the Hand After Brachial Embolectomy. European Journal of Vascular and Endovascular Surgery, 17(5), 446-447. doi: 10.1053/ejvs.1998.0796
[24] Zaiko, M. N., Byts, Yu. V., & Kryshtal, N. V. (2017). Патофізіологія: підручник [Pathophysiology: a textbook]. К.: Медицина, 2017 – К.: Medicine, 2017.
How to Cite
Volotovska , N. V. (2020). Study of morphological changes in the kidney during modeling of ischemic-reperfusion injuries of the limb and massive blood loss. Biomedical and Biosocial Anthropology, (41), 5-10.