• Alexander Zarbock, Hugo Van Aken, and Christoph Schmidt.
• Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany.
• Curr Opin Anaesthesiol. 2015 Apr 1;28(2):165-71.

Purpose Of ReviewAlthough advancements in perioperative care have been made over the last decades, the perioperative outcome could not be improved adequately. Therefore, new therapeutic strategies are required to decrease morbidity and all-cause mortality in surgical patients. Remote ischemic preconditioning (RIPC), defined as brief and transient episodes of ischemia at a remote site before a subsequent injury of the target organ, is an adaptive response to protect for organ injury elicited by different stimuli. This review evaluates the current clinical evidence for RIPC as a potential tissue-protective strategy and discusses the underlying mechanism.Recent FindingsSeveral studies demonstrated the tissue-protective effect of RIPC in various organs, including the heart, brain, and kidney. However, the existence of controversial results may be explained by the fact that different study protocols were used and different patient populations were recruited.SummaryRIPC may offer a novel inexpensive and noninvasive therapeutic strategy to alleviate organ injury in the perioperative period. However, adequately powered, large, multicenter clinical studies are necessary to accurately determine whether ischemic conditioning can improve the clinical outcomes of patients at risk for ischemia-reperfusion injury.

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