The Effect of Cerium Oxide on Erythrocyte Deformability in Ischemia-Reperfusion Injury in Rats Administered Sevoflurane

Aim: Ischemia-reperfusion (IR) injury is a common problem in vascular surgery. Acute IR damage observed in the lower extremities, especially in aortic surgery, occurs following temporary cross-clamping of the abdominal aorta. Disruption in blood rheology disrupts microvascular blood flow, leading to exacerbation of microangiopathy. It is known that drugs used for anesthesia affect blood rheology, which is affected by many factors. Therefore, we aimed to investigate the effects of cerium oxide on erythrocyte deformability before sevoflurane anesthesia in rats with lower extremity IR. Material and Methods: After approval by the ethics committee, 30 rats were randomly divided into 5 groups. Control (group C), IR (group IR), IR-cerium oxide (group IRCO), IR-sevoflurane (group IRS), IR-cerium oxide-sevoflurane (group IRCOS). Infrarenal abdominal aorta and atraumatic microvascular clamp were placed in IR groups 30 minutes after intraperitoneal cerium oxide was administered at a dose of 0.5 mg / kg. One hundred and twenty minutes later, the clamp was removed and reperfused for 120 minutes. Sevoflurane was applied at a rate of 2.3% at 4 L/min and 100% oxygen during IR for the minimum alveolar concentration to be 1 for rats. All rats were administered intraperitoneal ketamine (100 mg/kg) and euthanasia was performed by taking blood from the abdominal aorta. Erythrocytes were obtained from heparinized whole blood samples. Deformability measurements were made in erythrocyte suspensions in phosphate-buffered saline. A constant flow filtrometer system was used for the measurement of erythrocyte deformability and relative resistance was calculated. Results: Erythrocyte deformability index was found to be significantly different between the groups (p=0.002). Compared to the control group, the erythrocyte deformability index was significantly higher in IR and IRS groups (p<0.0001, p=0.003, respectively). In the IRCO and IRCOS groups, the erythrocyte deformability index was found to decrease significantly compared to the IR group (p=0.008, p=0.025, respectively). The erythrocyte deformability index was similar in Group C and in the IRCO and IRCOS groups (p=0.453, p=0.120, respectively). Discussion: We determined that cerium oxide administered intraperitoneally 30 minutes before ischemia in rats corrects the erythrocyte deformability deteriorated in IR-generated rats. We also found that cerium oxide had beneficial effects by reversing undesirable effects of IR. Further studies with larger volumes are required to support our promising results