The Critical Care Commute Podcast Ischemia Reperfusion Syndrome with Prof. Mervyn Singer
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Jun 17, 2025 
Prof. Mervyn Singer, an ICU physician and critical care thought leader, shares insights on ischemia-reperfusion syndrome, a paradox where restoring blood flow can worsen injury. He breaks down the complex mechanisms at play, such as mitochondrial involvement and oxidative stress. The conversation delves into the variability in physiological responses to stress, advocating for a tailored approach to ICU interventions. Prof. Singer emphasizes the importance of clinical judgment and flexibility in treatment protocols, aiming for patient-centered care.
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Reperfusion Injury Paradox
- Reperfusion injury causes harm by a paradoxical inflammatory and oxidative burst when oxygen returns.
- This damage is non-evolutionary and results from sudden reintroduction of oxygen after ischemia.
Mitochondria and Calcium Roles
- Mitochondria generate excessive reactive oxygen species upon reperfusion, causing cell damage.
- Calcium influx worsens cell injury and death through oxidative stress and membrane rupture.
Clinical Contexts of Injury
- Ischemia-reperfusion injury occurs in stroke, cardiac arrest, bypass surgery, vascular surgery, and transplantation.
- Timing and organ-specific context determine the injury severity and clinical manifestation.