Cardioprotective effect of remote ischemic postconditioning on children undergoing cardiac surgery: a randomized controlled trial. Issue 8 (13th May 2013)

• Record Type: Journal Article
• Authors: Zhong, Haixing; Gao, Zijun; Chen, Min; Zhao, Jing; Wang, Feng; Li, Liya; Dong, Hailong; Liu, Lixin; Wang, Qiang; Xiong, Lize; Hammer, Greg
• Is Part Of: Paediatric anaesthesia. Volume 23:Issue 8(2013)
• Page Start: 726
• Page End: 733
• Publication Date: 2013-05-13
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12181
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" xml:lang="en" id="pan12181-abs-0001"> <title>Summary</title> <sec id="pan12181-sec-0001" sec-type="section"> <title>Background</title> <p>Remote ischemic postconditioning (RPostC) is a noninvasive intervention that has demonstrated cardioprotection and neuroprotection in animal studies.</p> </sec> <sec id="pan12181-sec-0002" sec-type="section"> <title>Objective</title> <p>Our goal was to investigate the cardio‐cerebral protective effects of RPostC on children undergoing open‐heart surgery for repair of congenital heart defects (CHD).</p> </sec> <sec id="pan12181-sec-0003" sec-type="section"> <title>Methods</title> <p>Children undergoing open‐heart repair of CHD were randomly assigned to a RPostC or control group. RPostC was induced by three 5‐min cycles of lower limb ischemia and reperfusion using a blood pressure cuff (200 mmHg) at the onset of aortic unclamping. Serum cardiac troponin I (cTnI), creatine kinase‐MB (CK‐MB), neuron‐specific enolase (NSE), S100β, cytokines, and clinical outcomes were assessed.</p> </sec> <sec id="pan12181-sec-0004" sec-type="section"> <title>Results</title> <p>There were 35 children in the control group and 34 in the RPostC group. The mean age (3.64 ± 1.95 years vs. 3.45 ± 3.02 years, <italic>P </italic>= 0.80), weight (15.11 ± 6.91 kg vs. 13.40 ± 6.33 kg, <italic>P </italic>= 0.37), surgical time (144.82 ± 38.51 min vs. 129.92 ± 30.76 min, <italic>P </italic>= 0.15), and bypass time (78.01 ± 27.22 min vs. 72.52 ± 26.05 min, <italic>P </italic>= 0.49) were not different. Compared with the control group, the postoperative levels of cTnI (<italic>P </italic>= 0.037) and CK‐MB (<italic>P </italic>= 0.046) were significantly reduced in the RPostC group. Furthermore, the MAP was higher (<italic>P </italic>= 0.008), and ICU stay (36.87 ± 3.30 h vs. 60.57 ± 7.35 h, <italic>P </italic>= 0.006) and postoperative hospital stay (8.56 ± 1.50 days vs. 10.06 ± 2.41 days, <italic>P </italic>= 0.048) were shorter in the RPostC group than in the control group. However, the postoperative CVP and the concentrations of NSE, S100β, CRP, TNF‐α, IL‐1β, IL‐6, and IL‐10 were not significantly different.</p> </sec> <sec id="pan12181-sec-0005" sec-type="section"> <title>Conclusion</title> <p>RPostC significantly alleviates cardiac injury in children undergoing open‐heart repair of CHD and may also reduce cerebral injury.</p> </sec> </abstract>