Role of clotrimazole in lung injury in an experimental model of ruptured abdominal aortic aneurysm

PURPOSE: The risk of death with surgical treatment of ruptured abdominal aorticaneurysm (RAAA) with ischemia of the lower torso and hemorrhagic shock is 50-70%.The most important reason for RAAA is multiple organ failure and the lungs are the mostaffected remote organs. The purpose of this study is to evaluate the effect of clotrimazole,which is a potent antimycotic drug on lung injury in rats by creating an experimentalmodel RAAA.MATERIALS AND METHODS: Twenty six male Sprague-Dawley rats, in weightsof 420 ± 56 g, were divided into 5 groups as Sham (n = 6), SIR (n = 9), sham + CT (n = 6),Sham + PEG (n = 6), and SIR + CT (n = 9). Laparotomy and aortic exploration wereperformed in all groups under anesthesia with Ketamine and Xylazine and carotid arteryand jugular vein canulated. In Sham groups saline, Clotrimazole (CT) and polyethyleneglycol (PEG) were administered without shock and IR were developed. In SIR and SIR +CT groups, hemorrhagic shock was developed by drawing blood through one hour as tokeep average arterial pressure at 50mmHg, then ischemia was developed by clamping theabdominal aorta in two locations before the supramesenteric and iliac bifurcation. After 1hour SIR group was given 1ml saline and SIR + CT group was given 30mg/kg CT thenaortic clamps were opened and left for 2 h reperfusion. Half of the blood which was drawnin order to develop hemorrhagic shock was given back during the ischemic process and theremainder was given back during reperfusion process. at the end of the Reperfusionprocess of euthanasia was performed by drawing blood and serum malondialdehyde(MDA), myeloperoxidase (MPO), tumor necrosis factor (TNFa), interleukin-6 (IL-6),ischemia modified albumin (IMA), and blood gases were examined. The left lung removedand MDA, MPO and histological examination were performed in lung tissue.RESULTS: An increase was observed in all parameters except IL-6 in the SIR group incomparison to sham groups. In SIR + CT group in serum and lung MDA levels wereslightly decreased but it was not significant (p> 0.016). In SIR + CT group, the serumMPO, TNF?, and lung MPO values were decreased significantly (p <0.016). In SIR groupserum IMA values were increased significantly when compared with Sham groupswhereas in the SIR + CT group it was not decreased significantly (p> 0.016). Blood gasanalysis did not differ significantly between the groups (p> 0.016). In histopathologicexamination of the the SIR group diffuse interalveolar edema, leukocyte infiltration, andintraalveolar hemorrhage were observed. Whereas in the CT group, it is observed.