Experimental Study Of Mechanism And Treatment In Multiple Organ Dysfunction Syndrome After Crush Injury

Objective The study of mechanism and experimental treatment in multiple organ dysfunction syndrome (MODS) after crush injury.Methods (1) It was reproduced that an animal model of multiple organ dysfunction syndrome after crush injury in rabbits. The hindlimbs were crushed by 32 kg weight of stone for 4 hours or 5 hours in rabbits. It was grouped as crush 4 hours group (n=20), crush 5 hours (n=20) and normal group (n=10). Hematocrit (Hct)-. thrombocyte, glutamic-pyruvic transaminase(GPT) and creatinine(Cr) in blood were determined in 24 hour after crush injury. Protein contents in plasma and in broncho-alveolus lavage fluid (BALF) were determinedCells in hu^ liven kidney ^ intestine and skeletal muscle tissue were observed under microscope in 24 hour after crush injury. (2) The study of mechanism and experimental treatment in multiple organ dysfunction syndrome after crush injury. It was reproduced that an animal model of multiple organ dysfunction syndrome after crush injury by 32 kg for 5 hours in rabbits and injected by drugs in vein before and after crush injury respectively. It was grouped as CoQ10 group(n=8), mannitol group (n=9), VitC group (n=9), normal saline (NS) group (n=10), normal group (n=10). The arteral blood pressure were determined within 2 hours after crush injury. N-acetyl- P -D-glucosaminidase (NAG) -. superoxide dismutase (SOD) , malondialdehyde (MDA)> nitric oxide (NO) in plasma and MDA-. NO in heart, lung., liver, kidney , intestine and skeletal muscle tissue were determined GPT and Cr in plasma-, protein in BALF/plasma, NAG in urinal were studied in 24 hour after crush injury. Cells in heart, lung, liver, kidney, intestine and skeletal muscle tissue in allgroups were observed under microscope in 24 hour after crush injury.Results (1) The arteral blood pressure in crush 5h group was greater than that in crush 4h group within 2 hours after crush injury (p<0.05). The incidence of multiple system organ failure (MSOF) in crush 5h group was 60.0% vs in crush 4h group 35.0% (p>0.05). The percentage of liver, kidney, lung, intestine and coagulation system failure was respectively 60.0%, 55.0%, 40.0%, 30.0% and 25.0%. Hct was 55.6%?3.0% in crush 5h group and 48.5%?1.4% in crush 4h group (p>0.05). There were cells injury in two groups in 24 hour after crush injury. (2) The arteral blood pressure in treatment groups was higher than that in NS group during 2 hours after crush injury (p<0.05). The contents of NAG, MDA, NO in plasma in treatment groups were signicantly lower than those in NS group during 24 hours after crush injury (p<0.05),but SOD activity in plasma in treatment groups higher those in NS group within 2 to 24 hours after crush injury (p<0.05). The contents of MDA and NO in heart, lung, liver, kidney, intestine and skeletal muscle tissue in treatment groups were lower than those in NS group but higher than those in normal group. The incidence of MSOF in CoQ10, mannitol and VitC groups was respectively 25.0%, 333%, 333%, but 60.0% in NS group. NAG in urinal, protein in BALF/plasma-, Hct in treatment groups was lower than those in the NS group in 24 hour after crush injury (p<0.05). crush injury may induce cellular injury in heart, lung, liver, kidney, intestine and skeletal muscle tissues in 24 hour after crush injury but cellular injury was reduced by CoQ10, mannitol and VitC treatment.Conclusion (1) The animal model of MODS after crush injury was reproduced that the hindlimbs in rabbits were crushed by 32 kg weight of stone for 5 hours. (2) MODS after crush injury was induced by ischemia reperfusion injury. Free redicals in ischemia reperfusion injury play an important role in organ, tissue and celluar injury. Using freeradical scavengers before ischemic or , and reperfusion, such as coenzyme Q10, mannilol, vitamin C, can precaution and treat MODS after crush injury before ischemicor , and reperfusion.