Vascular Reperfusion Injury

Excerpt

Vascular reperfusion injury, also known as the ischemic-reperfusion injury, is a paradoxical concept that is still under exploration, where reperfusion can occasionally exacerbate the cellular damage already caused by ischemia/hypoxia. Sepsis, acute coronary syndrome, cerebral infarct, organ transplant, and limb injuries are some of the most commonly encountered pathologies resulting in ischemia. The idea stems from the fact that when there is massive blood loss, a thrombus, or an embolism present, the blood, as well as oxygen supply to the organs, is compromised, resulting in cellular damage.

Post revascularization, there is a sudden increase in blood and oxygen flow that triggers the activation of the inflammatory process, release of cytokines, and results in further damage to cells and their membranes. This usually forms the under-lying mechanism of post-ischemic complications. Organs usually involved in vascular reperfusion injury are heart, brain, liver, skeletal muscles, gut, and kidneys, but it can also induce systemic inflammation, eventually leading to multi-organ failure.