The investigators attempt to investigate the organ protective effect of remote ischemic conditioning in patients undergoing non-cardiac surgery with history of ischemic heart disease.
When adult patients with ischemic heart disease undergo non-cardiac surgery, perioperative ischemic complication may occur. These morbidity results in poor clinical outcomes. The incidence of perioperative myocardial ischemic event has been reported to be up to 19.7%. Remote ischemic preconditioning (RIPC) is a concept that a brief ischemic reperfusion of upper or lower extremity can transfer protection to the other vital organs from sustained ischemic reperfusion injury. Although RIPC is extensively studied in high risk cardiovascular surgery, it has not been tested in a non-cardiac surgery patients with a history of ischemic heart disease. Major organ injury including heart, lung and kidney will be evaluated in this randomized controlled trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
60
three cycles of ischemia (5 min) / reperfusion (5 min) of available upper or lower limb with an automated machine using blood pressure cuff
The patients had the same pneumatic cuff around the upper arm and similar maneuvers were performed, but pressure was not applied to the cuff.
Seoul National University Hospital
Seoul, South Korea
Troponin-I
Time frame: postoperative day one
Cardiac enzyme blood level (Creatinine Kinase, Creatinine Kinase -Myocardial Band)
Time frame: immediate postoperative
Cardiac enzyme blood level (Creatinine Kinase, Creatinine Kinase -Myocardial Band)
Time frame: postoperative day one
Cardiac enzyme blood level (Creatinine Kinase, Creatinine Kinase -Myocardial Band)
Time frame: postoperative day two
Cardiac enzyme blood level (Creatinine Kinase, Creatinine Kinase -Myocardial Band)
Time frame: postoperative day four
Acute kidney injury
Acute kidney injury determined by AKIN criteria
Time frame: postoperative 48 hours
ST-II segment analysis by Electrocardiography
Time frame: every 30 minutes during surgery
Oxygenation index (PaO2/FiO2)
Time frame: 5 minutes after anesthesia induction
Oxygenation index (PaO2/FiO2)
Time frame: 5 minutes before the end of surgery
Oxygenation index (PaO2/FiO2)
(at PACU)
Time frame: 20 minutes after the end of surgery
Oxygenation index (PaO2/FiO2)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: postoperative day one
length of hospital stay
length of hospital stay
Time frame: up to 24 week
length of ICU stay
length of ICU stay
Time frame: up to 24 week
Postoperative wound infection
Postoperative wound infection
Time frame: up to 24 week
Postoperative incidence of pneumonia
Postoperative incidence of pneumonia
Time frame: up to 24 week
Postoperative incidence of myocardial ischemic event
Postoperative incidence of myocardial ischemic event
Time frame: up to 24 week
Troponin-I
Time frame: immediate postoperative
Troponin-I
Time frame: Postoperative day two
Troponin-I
Time frame: Postoperative day four
Creatinine
Time frame: Immediate Postoperative
Creatinine
Time frame: Postoperative day one
Creatinine
Time frame: Postoperative day two
Creatinine
Time frame: Postoperative day four