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 language | English |
|---|---|
| Pages (from-to) | 467-475 |
| Number of pages | 9 |
| Journal | Chest |
| Volume | 142 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2012 Jan 1 |
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All Science Journal Classification (ASJC) codes
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
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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 journal › Article
TY - JOUR
T1 - Effect of combined remote ischemic preconditioning and postconditioning on pulmonary function in valvular heart surgery
AU - Kim, Jong Chan
AU - Shim, Jae Kwang
AU - Lee, Sak
AU - Yoo, Young Chul
AU - Yang, So Young
AU - Kwak, Younglan
PY - 2012/1/1
Y1 - 2012/1/1
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.
AB - 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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U2 - 10.1378/chest.11-2246
DO - 10.1378/chest.11-2246
M3 - Article
C2 - 22281799
AN - SCOPUS:84864818996
VL - 142
SP - 467
EP - 475
JO - Chest
JF - Chest
SN - 0012-3692
IS - 2
ER -