Review Article

Clinical Applications of Remote Ischemic Preconditioning

Table 1

Clinical trials to date in remote ischemic preconditioning.

YearnAuthorClinical settingConditioning protocolResults

20008GünyaydinCoronary artery bypass grafting (CABG)Arm 2 × 3 minLactate dehydrogenase (LDH) in preconditioned group
200512ChanClipping of cerebral aneurysm following subarachnoid haemorrhageProximal artery 2 min catheter occlusion, 30 min reperfusiontissue hypoxia (slower decline in pO2 and pH)
200641IliodromitisElective single vessel percutaneous coronary intervention (PCI) and stentingBoth arms 3 × 5 minIncreased troponin I, CK-MB, and C-reactive protein (CRP)
200637CheungPaediatric surgery for congenital cardiac defectsLeg 4 × 5 mintroponin T, post-op inotrope requirements, airway resistance
200782AliElective open abdominal aortic aneurysm repairInternal iliac cross-clamp 2 × 10 minabsolute risk of myocardial injury/infarction (troponin I) and renal injury (creatinine)
200757HausenloyElective CABGArm 3 × 5 mintroponin T
2008165FariesBalloon occlusion during carotid angioplasty and stentingTemporary balloon occlusion of ICADecreased Glasgow Coma Score (GCS) seen on initial balloon inflation not observed when blood reinflated
200945VenugopalCABG (cold-blood cardioplegia) +/− valve replacementArm 3 × 5 mintroponin T
2009242HooleElective PCIArm 3 × 5 mintroponin I, reduces ischaemic pain during PCI
200942HooleElective PCI for single vessel coronary artery diseaseArm 3 × 5 minNo effect on left ventricular dysfunction (conductance catheter/Doppler/dobutamine stress echocardiogram)
200940WalshEndovascular AAA repairBoth legs 10 min ischaemiaReduced urinary retinol binding protein and albumin : creatinine ratio
201070WalshCarotid endarterectomyBoth legs 10 min ischaemiaFewer saccadic latency deteriorations (did not reach statistical significance)
201078VenugopalCABGArm 3 × 5 minPost hoc analysis of 2 previous studies. Decreased Acute Kidney Injury (AKI) on Acute Kidney Injury Network (AKIN) criteria
2010162RahmanCABG (on-pump)Arm 3 × 5 minNo difference in trop T/cardiac performance/inotrope requirement/echo function/arrthymias/renal or lung outcomes
2010120WagnerCABG with cold crystalloid cardioplegiaArm 3 × 5 mintroponin I; tramadol administration increased troponin
201051WalshOpen infrarenal AAA repairSequential common iliac clampingNo differences in renal outcomes (urinary retinol binding protein (RBP) and albumin : creatinine ratio (ACR))
201060WenwuVentricular septal defect repairArm 3 × 5 min; 24 h and 1 h before surgeryReduced cytokines and cardiac enzymes, upregulation of heat shock protein (HSP) 70; improved lung compliance
201040HuElective decompression surgery for adult cervical spondylotic myelopathyArm 3 × 5 minReduced markers of ischaemic neuronal injury S-100B and neuron-specific enolase; improved recovery rate on functional score
2011120ZimmermanCardiac surgery with cardiopulmonary bypassLeg 3 × 5 minReduced relative risk of AKI on AKIN criteria
2011113PedersenPaediatric surgery for correction of complex cardiac defectsLeg 4 × 5 minNo effect on development of AKI, urine output, or urinary biomarkers
201176ChoiComplex valvular heart surgery with CPBLeg 3 × 5 minNo effect on creatinine, cystatin C, or neutrophil-gelatinase-associated lipocalin (NGAL), estimated glomerular filtration rate
Decreased CK-MB at 24 hours
2011242MunkPrimary PCI for acute MIArm 4 × 5 min, prehospitalModest improvement in LV systolic function (not significant)