Eschaemia during arterial reconstructive surgery. Biochemical changes as reflected in popliteal vein samples

Abstract

Blood gases, electrolytes, metabolites and enzymes were studied in the venous effluate from the leg and in the systemic blood of 8 patients suffering from obliterating arteriosclerosis, during and after reconstructive arterial surgery. The common femoral artery was clamped for 50 to 180 min. Marked hypoxia and acidosis, together with a rise in lactate, phosphate and creatinine concentrations were found in the popliteal vein samples. Changes in the electrolyte concentrations were also observed. The rises in K+ and Mg++ were most pronounced. None of the changes wre correlated to the occlusion time and only small inter-individual variations were recorded. Only minor systemic change occurred after restoration of blood flow. The maximum postoperative CPK-activity, however, was closely correlated to the occlusion time, but judging by the level of this activity the actual muscular damage caused by the ischaemia was moderate, even after prolonged arterial clamping.