Cardiopulmonary Protection of Modified Remote Ischaemic Preconditioning in Mitral Valve Replacement Surgery
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Myocardial Injury
- Sponsor
- Xuzhou Medical University
- Enrollment
- 86
- Locations
- 1
- Primary Endpoint
- Troponin I serum release over 24 hours after surgery
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
During cardiac surgery with cardiopulmonary bypass , injury occurs to the heart muscle and the lung.The heart and lung injury is a serious complication ,which increases both mortality and morbidity of cardiac surgery .Remote ischemic preconditioning(RIPC) with transient upper limb ischemia/reperfusion is a novel, simple, cost-free,non-pharmacological and non-invasive strategy.Recent some trials suggested that RIPC could provide myocardial protection by reducing serum cardiac biomarkers,however, more recent multicenter studies[9-11] had failed to show the protective effects of RIPC with respect to the troponin release and lung injury.
Remote ischemic preconditioning (RIPC) is reported to have the early-phase and delayed-phase organ protective effects, whether the modified RIPC protocol induced repeatedly has the cardiopulmonary protective effect is still uncertain.
Detailed Description
modified RIPC was induced at 24 h, 12 h and 1 h before surgery to reinforce the protective effects of RIPC.The single RIPC protocol was induced by three cycles of upper-limb ischemia, a standard blood-pressure cuff was placed on the ringt upper arm, then inflated the cuff to 200 mm Hg for 5 minutes, followed by 5 min of cuff deflation.
Investigators
Su Liu
M.D/Ph.D
Xuzhou Medical University
Eligibility Criteria
Inclusion Criteria
- •Patients undergoing heart surgery on cardiopulmonary bypass
- •Patients aged 18 years to 80 years
Exclusion Criteria
- •Inability to give informed consent
- •Cardiogenic shock
- •Cardiac arrest on current admission
- •Left ventricular ejection fraction less than 30%
- •Current atrial fibrillation
- •Preoperative use of inotropics or mechanical assist device
- •Patients with significant hepatic dysfunction (Prothrombin\>2.0 ratio)
- •Patients with known renal failure with a GFR\<30 mL/min/1.73 m2
- •Patients with significant pulmonary disease (FEV1\<40% predicted)
- •Recent myocardial infarction (within 7 days)
Outcomes
Primary Outcomes
Troponin I serum release over 24 hours after surgery
Time Frame: 24 hours post surgery
Secondary Outcomes
- salveolar-arterial oxygen gradient over 24 hours after surgery(24 hours post surgery)
- PaO2/FiO2 ratio over 24 hours after surgery(24 hours post surgery)
- Inotrope score(12 hours post surgery)