This phenomenon is not confined to the bowel as other organs and systems may also suffer when a reduction in blood flow is followed by revascularization or successful resuscitation. The release of mediators initially causes regional damage but with spillage into the systemic circulation other organs or systems are affected. Ischaemia-reperfusion injury to the lower limb may lead to non-cardiogenic pulmonary oedema and changes in intestinal morphology. Similarly, reperfusion of ischaemic bowel may damage the liver parenchyma and lungs. Such local and remote organ injuries may be abrogated by pretreatment with ibuprofen and mannitol, suggesting that the generation of oxygen-derived free radicals and the activation of the arachidonic acid cascade have important roles to play.
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