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Related Experiment Video

Updated: Apr 15, 2026

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Remote Ischemic Conditioning After Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis.

Jorge H Mejía-Mantilla1, Felipe Mejía-Herrera2, Néstor Zapata2

  • 1Department of Intensive Care Medicine, Fundación Valle del Lili, University Hospital, Cali, Colombia. Jorge.mejia@fvl.org.co.

Neurocritical Care
|April 13, 2026
PubMed
Summary

Remote ischemic conditioning (RIC) did not show significant benefits for reducing mortality or improving neurological outcomes in patients with subarachnoid hemorrhage (SAH). Further standardized research is needed to confirm any therapeutic effects of RIC for SAH management.

Keywords:
Cerebral vasospasmCerebral AneurysmDelayed cerebral ischemiaIschemia limb preconditioningIschemic conditioningNeurologic outcomesRemote ischemic preconditioningStrokeSubarachnoid hemorrhage

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Area of Science:

  • Neurology
  • Cardiovascular Research
  • Critical Care Medicine

Background:

  • Subarachnoid hemorrhage (SAH) poses risks of delayed cerebral ischemia (DCI).
  • Remote ischemic conditioning (RIC) is a potential intervention to mitigate ischemic injury.
  • This review assesses RIC's effectiveness in SAH patients.

Purpose of the Study:

  • To evaluate the efficacy of remote ischemic conditioning (RIC) in patients diagnosed with subarachnoid hemorrhage (SAH).
  • To determine if RIC reduces mortality, delayed cerebral ischemia (DCI), or improves neurological status in SAH patients.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies.
  • Searched for studies comparing RIC with control or sham procedures in adult SAH patients.
  • Assessed risk of bias using Cochrane RoB 2.0 and ROBINS-I tools; analyzed data using random-effects meta-analysis.

Main Results:

  • Included 5 studies (4 RCTs, 1 cohort) with 200 patients.
  • RIC showed no statistically significant effect on mortality (RR=0.69), cerebral infarction (RR=1.04), or unfavorable neurological outcomes (RR=0.73).
  • Variability in outcome reporting prevented pooled analysis for vasospasm.

Conclusions:

  • Current evidence does not support the efficacy of RIC for managing SAH.
  • Lack of standardized protocols and definitions hinders confirmation of therapeutic effects.
  • More rigorous and uniform trials are required to establish RIC's potential benefits in SAH.