Effect of combined remote ischemic preconditioning and postconditioning on pulmonary function in valvular heart surgery

Jong Chan Kim, Jae Kwang Shim, Sak Lee, Young Chul Yoo, So Young Yang, Younglan Kwak

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: The aim of this study was to evaluate the lung-protective effect of combined remote ischemic preconditioning (RIPCpre) and postconditioning (RIPCpost ) in patients undergoing complex valvular heart surgery. Methods: In this randomized, placebo-controlled, double-blind trial, 54 patients were assigned to an RIPCpre plus RIPCpost group or a control group (1:1). Patients in the RIPCpre plus RIPCpost group received three 10-min cycles of right-side lower-limb ischemia of 250 mm Hg at both 10 min after anesthetic induction and weaning from cardiopulmonary bypass. The primary end point was to compare postoperative PaO2/FIO2. Secondary end points were to compare pulmonary variables, incidence of acute lung injury, and inflammatory cytokines. Results: In both groups, PaO2/FIO2 at 24 h postoperation was significantly decreased compared with each corresponding baseline value. However, intergroup comparisons of pulmonary variables, including PaO2/FIO2 and incidence of acute lung injury, revealed no significant differences. Serum levels of IL-6, IL-8, IL-10, and tumor necrosis factor-α were all significantly increased in both groups compared with each corresponding baseline value, without any significant intergroup differences. There were also no significant differences in transpulmonary gradient of IL-6, IL-10, and tumor necrosis factor- a between the groups. Conclusions: RIPC pre plus RIPCpost as tested in this randomized controlled trial did not provide significant pulmonary benefit following complex valvular cardiac surgery. Trial registry: ClinicalTrials.gov; No.: NCT01427621; URL: www.clinicaltrials.gov.

Original languageEnglish
Pages (from-to)467-475
Number of pages9
JournalChest
Volume142
Issue number2
DOIs
Publication statusPublished - 2012 Jan 1

Fingerprint

Ischemic Postconditioning
Ischemic Preconditioning
Thoracic Surgery
Lung
Acute Lung Injury
Interleukin-10
Interleukin-6
Tumor Necrosis Factor-alpha
Incidence
Cardiopulmonary Bypass
Interleukin-8
Registries
Anesthetics
Lower Extremity
Ischemia
Randomized Controlled Trials
Placebos
Cytokines
Control Groups
Serum

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Jong Chan ; Shim, Jae Kwang ; Lee, Sak ; Yoo, Young Chul ; Yang, So Young ; Kwak, Younglan. / Effect of combined remote ischemic preconditioning and postconditioning on pulmonary function in valvular heart surgery. In: Chest. 2012 ; Vol. 142, No. 2. pp. 467-475.
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Effect of combined remote ischemic preconditioning and postconditioning on pulmonary function in valvular heart surgery. / Kim, Jong Chan; Shim, Jae Kwang; Lee, Sak; Yoo, Young Chul; Yang, So Young; Kwak, Younglan.

In: Chest, Vol. 142, No. 2, 01.01.2012, p. 467-475.

Research output: Contribution to journalArticle

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N2 - Background: The aim of this study was to evaluate the lung-protective effect of combined remote ischemic preconditioning (RIPCpre) and postconditioning (RIPCpost ) in patients undergoing complex valvular heart surgery. Methods: In this randomized, placebo-controlled, double-blind trial, 54 patients were assigned to an RIPCpre plus RIPCpost group or a control group (1:1). Patients in the RIPCpre plus RIPCpost group received three 10-min cycles of right-side lower-limb ischemia of 250 mm Hg at both 10 min after anesthetic induction and weaning from cardiopulmonary bypass. The primary end point was to compare postoperative PaO2/FIO2. Secondary end points were to compare pulmonary variables, incidence of acute lung injury, and inflammatory cytokines. Results: In both groups, PaO2/FIO2 at 24 h postoperation was significantly decreased compared with each corresponding baseline value. However, intergroup comparisons of pulmonary variables, including PaO2/FIO2 and incidence of acute lung injury, revealed no significant differences. Serum levels of IL-6, IL-8, IL-10, and tumor necrosis factor-α were all significantly increased in both groups compared with each corresponding baseline value, without any significant intergroup differences. There were also no significant differences in transpulmonary gradient of IL-6, IL-10, and tumor necrosis factor- a between the groups. Conclusions: RIPC pre plus RIPCpost as tested in this randomized controlled trial did not provide significant pulmonary benefit following complex valvular cardiac surgery. Trial registry: ClinicalTrials.gov; No.: NCT01427621; URL: www.clinicaltrials.gov.

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