use of various serum indicators as markers for the extent of muscle necrosis in acute limb ischaemia; an experimental study

ABSTRACT

This experimental study aimed at the determination of an objective parameter that could help differentiate between severe but reversible acute limb ischaemia and irreversible muscle damage. The experiment included 16 dogs that were divided into 4 groups [plus a control group of 7 dogs]. These dogs were subjected to acute ischaemia of one pelvic limb. The duration of ischaemia was considered as followed; group [1] 3 hours, group [2] 6 hours, group [3] 12 hours and group [4] 21 hours. A systemic venous sample was obtained at the end of the duration of ischaemia and was assessed for the following; myoglobin, creatine kinase [CK], lactate dehydrogenase [LDH] and aspartate aminotransferase [AST]. At the end of duration of ischaemia, a gastrocnemius muscle biopsy was also taken from each of the ischaemic limbs for assessment of the extent of muscle ischaemia and necrosis. Comparisons were made between various marker levels at different intervals and their control levels. For each marker, levels at various ischaemic intervals were also compared to one another. The results revealed increase in levels of the markers at different intervals with a peak value at 6 hours [of statistical significance for all with the exception of LDH], followed by a subsequent decline to lower levels mostly comparable to the 3- hour ischaemic period levels