Methods: The experiments were performed on 35 male Wistar albino rats weighing mean 219±26 g. The rats were randomly assigned into five groups, including each of seven rats. Rats were pretreated with cilostazol and levosimendan, alone or in combination, and then lower extremities were subjected to I/R induced by a infrarenal aortic occlusion for duration of 120 minutes, followed by a-60 minute- reperfusion. The rats were sacrificed under deep anesthesia and the lung tissues were removed. Malondialdehyde (MDA) levels, superoxide dismutase (SOD) activity, and glutathione (GSH) levels were measured in the lung tissues. The tissue samples were further examined histopathologically under light microscopy.

Results: It was found that I/R elevated MDA levels accompanied by a reduction in SOD activities and GSH levels (p<0.05). Cilostazol and levosimendan, and their combination restored MDA levels, SOD activity, GSH levels and lung injury scores (p<0.05). There was no significant difference among individual or combined treatment of these agents (p>0.05).

Conclusion: In light of these findings, cilostazol and levosimendan may be useful for protecting the lung tissue from I/R injury, before limb ischemia in vascular surgery. However, the combined use of these agents does not further increase the protection from I/R injury.