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Updated: May 11, 2026
Remote Limb Ischemic Preconditioning: A Neuroprotective Technique in Rodents
Published on: June 2, 2015
Cardioprotective effect of remote ischemic postconditioning on children undergoing cardiac surgery: a randomized
Haixing Zhong1, Zijun Gao, Min Chen
1Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Insights
Remote ischemic postconditioning (RPostC) reduces cardiac injury in children undergoing open-heart surgery for congenital heart defects (CHD). This noninvasive method also shows potential for reducing cerebral injury in pediatric patients.
Area of Science:
- Cardiology
- Pediatric Surgery
- Neuroprotection
Background:
- Remote ischemic postconditioning (RPostC) is a noninvasive technique with demonstrated cardioprotective and neuroprotective effects in animal models.
- Its potential benefits in pediatric patients undergoing complex cardiac procedures remain an area of active investigation.
Purpose of the Study:
- To evaluate the cardio-cerebral protective effects of RPostC in children undergoing open-heart surgery for congenital heart defects (CHD).
Main Methods:
- Children with CHD were randomized into RPostC or control groups.
- RPostC involved three 5-minute cycles of lower limb ischemia and reperfusion at aortic unclamping.
- Postoperative assessment included cardiac enzymes (cTnI, CK-MB), neurological markers (NSE, S100β), cytokines, and clinical outcomes.
Main Results:
- The RPostC group showed significantly reduced postoperative levels of cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) compared to the control group.
- Mean arterial pressure (MAP) was higher, and intensive care unit (ICU) and hospital stays were shorter in the RPostC group.
- No significant differences were observed in neurological markers (NSE, S100β) or inflammatory cytokines.
Conclusions:
- RPostC significantly alleviates cardiac injury in pediatric patients undergoing open-heart repair for CHD.
- The findings suggest RPostC may also offer protective effects against cerebral injury in this population.
Background:
Remote ischemic postconditioning (RPostC) is a noninvasive intervention that has demonstrated cardioprotection and neuroprotection in animal studies.
Objective:
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).
Methods:
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.
Results:
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, P = 0.80), weight (15.11 ± 6.91 kg vs. 13.40 ± 6.33 kg, P = 0.37), surgical time (144.82 ± 38.51 min vs. 129.92 ± 30.76 min, P = 0.15), and bypass time (78.01 ± 27.22 min vs. 72.52 ± 26.05 min, P = 0.49) were not different. Compared with the control group, the postoperative levels of cTnI (P = 0.037) and CK-MB (P = 0.046) were significantly reduced in the RPostC group. Furthermore, the MAP was higher (P = 0.008), and ICU stay (36.87 ± 3.30 h vs. 60.57 ± 7.35 h, P = 0.006) and postoperative hospital stay (8.56 ± 1.50 days vs. 10.06 ± 2.41 days, P = 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.
Conclusion:
RPostC significantly alleviates cardiac injury in children undergoing open-heart repair of CHD and may also reduce cerebral injury.
