Tesis

Derajat Perubahan Histopatologi Jaringan Paru Kelinci pada Keadaan Iskemia Peperfusi Tungkai Bawah Akut yang mendapatkan Perlakuan Ischemic Preconditioning dan Hipotermia = Protective Effect of Ischemic preconditioning and hypothermia in Remote Acute Lung Reperfusion Injury induced by Lower Limb ischemia in Rabbit. Histopathology Review

Latar Belakang : Iskemia yang terjadi di suatu lokasi di tubuh mengakibatkan
kerusakan pada lokasi yang berjauhan yang dikenal dengan sebutan cedera
remote reperfusi. Paru merupakan salah satu organ target utama terjadinya
kerusakan pada cedera remote reperfusi. Penelitian ini bertujuan melihat efek
protektif hipotermia dan ischemic preconditioning (IPC) terhadap cedera remote
reperfusi di paru.
Metode : Dilakukan penelitian eksperimental pada kelinci New Zealand White
(n=18) dengan satu kelompok kontrol (iskemia) dan dua kelompok perlakuan
(preconditioning dan hipotermia). Dilakukan ligasi a. iliaca communis kanan
selama 4 jam, hipotermia sedang (28
o
C), dan iskemia pre-conditioning pada
masing-masing kelompok. Kemudian kelinci dibiarkan hidup selama 8 jam.
Sampel jaringan paru di ambil untuk pemeriksaan derajat kerusakan paru secara
histopatologi.
Hasil : Terdapat perbedaan bermakna derajat perubahan histopatologik jaringan
paru yang di berikan perlakuan IPC (p : 0,000) dan perlakuan Hipotermi (p :
0,015) terhadap kelompok kontrol
Kesimpulan : Ischemic preconditioning dan Hipotermi memberikan efek
protektif pada paru dari akibat iskemik reperfusi tungkai bawah akut.


Introduction. Acute lower limb ischemia may induced ischemia reperfusion injury to the
lung and also initiate a systemic inflammatory response syndrome. The aim of this study
was to proofed whether IPC and hypothermia of the limb before I/R injury would also
attenuates the acute lung injury in rabbit model of hind limb I/R.
Method. This prospective, randomized, controlled, experimental animal study was
performed in a university-based animal research facility with 18 New Zealand White
Rabbit. The rabbits were randomized (n=6 per group) into three groups: I/R group (4
hours of hind limb ischemia and 8 hours of reperfusion), IPC group (three cycles of 5
minutes of ischemia/5 minutes of reperfusion immediately preceding I/R), and
hypothermia ( 28
o
C) together with 4 hours of hind limb ischemia and 8 hours of
reperfusion. Lung tissue were examined based for their histopathological changes. The
changes were assessed based on the grading as normal, mild, moderate, and severe
damage.
Result. Rabbit treated with IPC (p : 0,001) and hypothermia (p : 0,015) have
demonstrated a significant decrease in histopathological features of acute lung
reperfusion injury.
Conclusion. Ischemic preconditioning and hypothermia have shown protective effect for
the lung from remote ischemic reperfusion injury induced by lower limb ischemia.