Effect of Combined Remote Ischemic Preconditioning and Postconditioning on Acute Pulmonary Injury in Patients Undergoing Valvular Heart Surgery

Overview

Pulmonary dysfunction after cardiac surgery with CPB remains to be a problem complicating the postoperative course of the patients. The investigators hypothesized that RIPCcom, combined intervention of remote ischemic preconditioning and remote ischemic postconditioning, would confer beneficial influence on inflammatory response and resultant postoperative pulmonary dysfunction after CPB in patients undergoing complex valvular heart surgery who are at increased risk of postoperative pulmonary dysfunction.The aim of this study was to evaluate the lung-protective effect of combined remote ischemic pre- and post-conditioning in patients undergoing complex valvular heart surgery.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: Triple (Participant, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: November 2010

Interventions

  • Procedure: remote ischemic pre and postconditioning (RIPC)
    • RIPCcom group: combined intervention of remote ischemic pre- and postconditioning consisted of three 10-minute cycles of right lower limb ischemia, which was induced with an automated cuff-inflator placed on the right upper leg and inflated to 250 mmHg, with an intervening 10 minute of reperfusion during which the cuff was deflated. This intervention were performed at 10 minutes after induction of anesthesia and then 10 min after weaning from CPB.

Arms, Groups and Cohorts

  • Experimental: RIPCcom group
  • No Intervention: Control group

Clinical Trial Outcome Measures

Primary Measures

  • Comparison of postoperative PaO2/FiO2
    • Time Frame: at 10 minutes after anesthetic induction
    • Comparison of postoperative PaO2/FiO2 between RIPCcom group and Control group.

Participating in This Clinical Trial

Inclusion Criteria

  • patients undergoing valvular heart surgery.
  • Age: 20~80.

Exclusion Criteria

  • Emergency operation.
  • patients with peripheral vascular disease.
  • Patients with a known history or clinical evidence of chronic obstructive pulmonary disease.
  • Patients with hepatic or renal dysfunction
  • Patients with acute myocardial infarction within 1 week before surgery

Gender Eligibility: All

Minimum Age: 20 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Yonsei University
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Young-Lan Kwak, MD, Ph.D, Principal Investigator, Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine

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