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Remote Ischemic Preconditioning has a Cardioprotective Effect in Children in the Early Postoperative Phase: A

Wen Tan1, Chaoji Zhang1, Jianzhou Liu1

  • 1Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.

Pediatric Cardiology
|January 6, 2018
PubMed

Insights

Remote ischemic preconditioning (RIPC) shows cardioprotective effects in pediatric patients undergoing heart surgery. This method reduces cardiac enzyme release and shortens recovery times, including ventilator support and ICU stay.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Critical Care Medicine

Background:

  • Congenital heart surgery in pediatric patients carries significant risks.
  • Identifying effective cardioprotective strategies is crucial for improving outcomes.
  • Remote ischemic preconditioning (RIPC) is a potential non-invasive intervention.

Purpose of the Study:

  • To evaluate the cardioprotective efficacy of RIPC in pediatric patients undergoing congenital heart surgery.
  • To synthesize evidence from randomized controlled trials (RCTs) on RIPC's impact on postoperative markers and recovery.
  • To assess the benefits of RIPC in the early postoperative phase.

Main Methods:

  • An updated meta-analysis was conducted.
  • Included 9 randomized controlled trials (RCTs) with a total of 793 pediatric patients (<18 years).
  • Analyzed data on troponin I release, inotropic scores, ventilator support, and ICU stay duration.

Main Results:

  • RIPC significantly reduced troponin I release 6 hours post-surgery (SMD -0.59, p=0.03).
  • RIPC mitigated inotropic scores at 4-6 hours (SMD -0.43, p=0.004) and 12 hours (SMD -0.26, p=0.03).
  • RIPC shortened ventilator support time (SMD -0.28, p=0.01) and ICU stay (SMD -0.21, p=0.004).

Conclusions:

  • Remote ischemic preconditioning demonstrates significant cardioprotective effects in pediatric patients post-congenital heart surgery.
  • RIPC positively impacts early postoperative recovery markers and resource utilization.
  • Further RCTs are warranted to explore the long-term cardiac benefits of RIPC in this population.

Keywords:
Congenital heart diseaseMyocardial injuryPediatric cardioprotectionRemote ischemic preconditioning

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