Revascularization syndrome

Abstract

The revascularization syndrome (SR) is a serious upset of the milieu interieur after restoration of the circulation in acute occlusion of the blood vessels of the extremities. The authors report, based on their own series of 192 patients with acute vascular occlusion, an incidence of SR in 8.3%. They found that in patients with SR the risk of death is seven times and the risk of loss of the extremity four times higher than in those who do not develop SR. If ischaemic changes in the tissues of the extremities are advanced and severe SR is imminent, revascularization must be abondoned and in order to save the patient's life the extremity must be sacrificed. Primary amputation must be considered in case of cadaveric rigidity of the extremity and fixed skin discoloration. As to biochemical changes it should be considered when the pH < 7.2, hyperkalaemia > 6 mmol/l and CPK > 200 μkat/l. The most effective prevention of SR is according to the authors restoration of the discontinued circulation, the recognition of SR and initiation of offensive treatment in the first (devascularization) stage of SR.