• Paediatric anaesthesia · Aug 2013

    Randomized Controlled Trial

    Cardioprotective effect of remote ischemic postconditioning on children undergoing cardiac surgery: a randomized controlled trial.

    • Haixing Zhong, Zijun Gao, Min Chen, Jing Zhao, Feng Wang, Liya Li, Hailong Dong, Lixin Liu, Qiang Wang, and Lize Xiong.
    • Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
    • Paediatr Anaesth. 2013 Aug 1;23(8):726-33.

    BackgroundRemote ischemic postconditioning (RPostC) is a noninvasive intervention that has demonstrated cardioprotection and neuroprotection in animal studies.ObjectiveOur goal was to investigate the cardio-cerebral protective effects of RPostC on children undergoing open-heart surgery for repair of congenital heart defects (CHD).MethodsChildren undergoing open-heart repair of CHD were randomly assigned to a RPostC or control group. RPostC was induced by three 5-min cycles of lower limb ischemia and reperfusion using a blood pressure cuff (200 mmHg) at the onset of aortic unclamping. Serum cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), neuron-specific enolase (NSE), S100β, cytokines, and clinical outcomes were assessed.ResultsThere were 35 children in the control group and 34 in the RPostC group. The mean age (3.64 ± 1.95 years vs. 3.45 ± 3.02 years, P = 0.80), weight (15.11 ± 6.91 kg vs. 13.40 ± 6.33 kg, P = 0.37), surgical time (144.82 ± 38.51 min vs. 129.92 ± 30.76 min, P = 0.15), and bypass time (78.01 ± 27.22 min vs. 72.52 ± 26.05 min, P = 0.49) were not different. Compared with the control group, the postoperative levels of cTnI (P = 0.037) and CK-MB (P = 0.046) were significantly reduced in the RPostC group. Furthermore, the MAP was higher (P = 0.008), and ICU stay (36.87 ± 3.30 h vs. 60.57 ± 7.35 h, P = 0.006) and postoperative hospital stay (8.56 ± 1.50 days vs. 10.06 ± 2.41 days, P = 0.048) were shorter in the RPostC group than in the control group. However, the postoperative CVP and the concentrations of NSE, S100β, CRP, TNF-α, IL-1β, IL-6, and IL-10 were not significantly different.ConclusionRPostC significantly alleviates cardiac injury in children undergoing open-heart repair of CHD and may also reduce cerebral injury.© 2013 John Wiley & Sons Ltd.

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