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Remote ischemic conditioning in necrotizing enterocolitis: an extended phase I safety study.

Yongfang Wu1, Niloofar Ganji2, Zhou Chen3

  • 1Neonatal Medical Center, Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital, Fujian, 361006, China.

Pediatric Surgery International
|December 20, 2025
PubMed
Summary

Remote ischemic conditioning (RIC) is safe for preterm infants with necrotizing enterocolitis (NEC). This study confirms RIC’s safety in neonates, even with extended application for both medical and surgical NEC cases.

Keywords:
Necrotizing enterocolitisRemote ischemic conditioningSafety study

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Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Critical Care

Background:

  • Necrotizing enterocolitis (NEC) is a serious condition in preterm infants.
  • Remote ischemic conditioning (RIC) shows potential as a novel therapeutic strategy for NEC.
  • Previous trials indicated RIC is safe in human premature neonates with NEC.

Purpose of the Study:

  • To further assess the safety of extended application of RIC in preterm infants diagnosed with NEC.
  • To evaluate the primary endpoint of perfusion returning to baseline within 5 minutes after RIC intervention.
  • To assess secondary endpoints including cutaneous injury and pain scores.

Main Methods:

  • A single-center, phase I, non-randomized trial was conducted.
  • Preterm infants (<36 weeks gestational age) with confirmed NEC received RIC intervention.
  • RIC involved two consecutive days of four 5-minute ischemia-reperfusion cycles.

Main Results:

  • Six preterm neonates with NEC were recruited and completed the RIC intervention.
  • All neonates showed normal arterial flow and limb perfusion return to baseline within 5 minutes post-intervention.
  • No new-onset skin lesions or significant differences in pain scores (PIPP) were observed.

Conclusions:

  • Remote ischemic conditioning (RIC) using 5-minute ischemia-reperfusion cycles is a safe intervention for preterm infants with NEC.
  • RIC is safe for extended application in extremely preterm neonates with both medical and surgical NEC.