Anesthesiologists are involved: Anesthesiologists are involved

Cellular edema may choke off adjacent capillaries and result in a "no-reflow" phenomenon that prevents the reversal ischemia in the presence of adequate macro perfusion.

Ischemic cells produce lactate and free radicals, which accumulate in the circulation if perfusion is diminished.

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• These compounds cause direct damage to the cell, as well as form the bulk of the toxic load that will be washed back to the central circulation when flow is reestablished.

• The ischemic cell will also produce and release a variety of inflammatory factors

• prostacyclin

• thromboxane

• prostaglandins

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