Anesthesiology
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Classical Article
Classic Papers Revisited: My Love Affair with the Venous System.
The Pathophysiology of Aortic Cross-clamping and Unclamping. By Gelman S. ANESTHESIOLOGY 1995; 82:1026-60. ⋯ Aortic cross-clamping is associated with the formation and release of many mediators which constitute a double-edged sword: they may mitigate or aggravate the harmful hemodynamic effects of AoX and unclamping. Injuries to the lungs, kidneys, spinal cord, or abdominal viscera are caused mainly by ischemia and reperfusion of organs distal to aortic cross-clamping. A clear understanding of the pathophysiologic mechanisms involved in these processes should help to promote rational, well-focused, and effective measures to prevent and treat homeostatic disturbances occurring during AoX and unclamping.