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Updated: May 25, 2026
Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents
Published on: June 2, 2015
Effects of remote ischemic preconditioning with postconditioning in patients undergoing off-pump coronary artery
Deok Man Hong1, Yunseok Jeon, Chang-Soon Lee
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University Hospital, Seoul, Korea.
Background:
Myocardial injury is associated with an adverse outcome after off-pump coronary artery bypass graft surgery (OPCAB). The authors conducted a randomized controlled trial to evaluate whether remote ischemic preconditioning (RIPC) with remote ischemic postconditioning (RIPostC) reduces myocardial injury in patients undergoing OPCAB.
Methods And Results:
Seventy patients scheduled for OPCAB were randomly assigned to an RIPC+RIPostC group (n=35) or a control group (n=35). In the RIPC+RIPostC group, 4 cycles of 5-min ischemia and 5-min reperfusion were done on a lower limb before anastomoses (RIPC) and after anastomoses (RIPostC). RIPC+RIPostC significantly reduced postoperative serum troponin I levels (P=0.001). The area under the curve for postoperative troponin I was 48.7% lower in the RIPC+RIPostC group (median [interquartile range], 21.3 h·ng⁻¹·ml⁻¹, 16.5-53.1 h·ng⁻¹·ml⁻¹ vs. 41.5 h·ng⁻¹·ml⁻¹, 24.6-90.2 h·ng⁻¹·ml⁻¹, P=0.020). There was no significant difference in creatinine levels and PaO₂/F(i)O₂ ratios between the 2 groups.
Conclusions:
RIPC+RIPostC by lower limb ischemia decreased postoperative myocardial enzyme elevation by almost half postoperatively in patients undergoing OPCAB.
