PMID- 25306677
OWN - NLM
STAT- MEDLINE
DCOM- 20141110
LR  - 20141013
IS  - 0201-7563 (Print)
IS  - 0201-7563 (Linking)
IP  - 3
DP  - 2014 May-Jun
TI  - [Effects of remote ischemic preconditioning on perioperative period in elective 
      aortic valve replacement].
PG  - 11-7
AB  - PURPOSE OF THE STUDY: To evaluate the effects of remote ischemic preconditioning 
      (RIPC) on the perioperative period in elective aortic valve replacement (AVR) 
      along different anaesthesia techniques. MATERIALS AND METHODS: 48 patients aged 
      50 to 75 years (64 (56;69)) which were scheduled for AVR due to aortic valve 
      stenosis were included into the prospective, randomized study. Four groups were 
      formed after randomization: 1) RIPC applied during propofol anesthesia (RIPCprop, 
      n = 12), 2) RIPC applied during sevoflurane anesthesia (RIPCsevo, n = 12), 3) 
      propofol anesthesia without RIPC (CONTROLprop, n = 12), 4) sevoflurane anesthesia 
      without RIPC (CONTROLsevo, n = 12). Groups were similar in baseline data of 
      patients. RIPC protocol: three five-minutes episodes of simultaneous both lower 
      limbs ischemia with five-minutes reperfusion intervals. Troponin I (cTrI), 
      interleukin-6 (IL-6), Interleukin-8 (IL-8) and C-reactive protein (CRP) levels 
      were assessed prior to induction of anesthesia, at 30 min, 6, 12, 24 and 48 hours 
      after the cessation of CPB. Significant differences were assessed by the 
      nonparametric Mann-Whitney and Fisher's exact tests. Data are presented as: 
      median (25th percentile, 75th percentile). RESULTS: . Significant differences in 
      cTnI were found between RIPCsevo and CONTROLsevo groups at 6, 12 and 24 hours: 
      1.68 (1.28, 2.09) ng/ml vs 3.66 (2.07, 4.49) ng/ml, respectively at 6 hours (p = 
      0.04); 1.89 (1.59, 2.36) ng/ml vs 3.66 (2.91, 5.64) ng/ml, respectively at 12 
      hours (p = 0.001); 1.68 (1.55; 2.23) ng/ml vs 3.32 (2.10; 5.46) ng/ml, 
      respectively at 24 hours (p = 0.01). There were no differences found in cTnI 
      between RIPCprop and CONTROLprop groups during the whole study. There were no 
      significant differences found in the levels of IL-6 and CRP between RIPC and 
      control groups during the whole study Unexpectedly significant excess 
      concentrations of IL-8 at 24 h were found when RIPC applied during sevoflurane 
      anesthesia: 12.3 (10.6, 14.4) pg/mL in RIPCsevo group vs 6.2 (4.8, 11.1) pg/ml in 
      CONTROLsevo group (p = 0.02). There was no paroxysmal atrial fibrillation (AF) 
      after RIPC, and 5 cases were registered in the control groups (p = 0.02). No 
      other significant differences in the clinical course of the postoperative period 
      were found. CONCLUSIONS: Cardioprotective effect of RIPC and its effect on 
      systemic inflammatory response should be assessed in the selected anesthesia 
      groups. RIPC on the background of sevoflurane anesthesia reduces myocardial 
      injury during AVR. RIPC does not reduce the severity of the systemic inflammatory 
      response after AVR. RIPC reduces the risk of AF after AVR.
FAU - Bautin, A E
AU  - Bautin AE
FAU - Galagudza, M M
AU  - Galagudza MM
FAU - Datsenko, S V
AU  - Datsenko SV
FAU - Tashkhanov, D M
AU  - Tashkhanov DM
FAU - Marichev, A O
AU  - Marichev AO
FAU - Bakanov, A Iu
AU  - Bakanov AIu
FAU - Malaia, E Ia
AU  - Malaia EIa
FAU - Naimushin, A V
AU  - Naimushin AV
FAU - Rubinchik, V E
AU  - Rubinchik VE
FAU - Gordeev, M L
AU  - Gordeev ML
LA  - rus
PT  - English Abstract
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Russia (Federation)
TA  - Anesteziol Reanimatol
JT  - Anesteziologiia i reanimatologiia
JID - 7705399
RN  - 0 (Cytokines)
RN  - 0 (Troponin I)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Aged
MH  - Anesthesia, General
MH  - Aortic Valve/*surgery
MH  - C-Reactive Protein/analysis
MH  - Cytokines/blood
MH  - Extracorporeal Circulation
MH  - Heart Valve Prosthesis Implantation/adverse effects/*methods
MH  - Humans
MH  - Ischemic Preconditioning/*methods
MH  - Middle Aged
MH  - Myocardial Reperfusion Injury/etiology/pathology/*prevention & control
MH  - Perioperative Period
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Troponin I/blood
EDAT- 2014/10/14 06:00
MHDA- 2014/11/11 06:00
CRDT- 2014/10/14 06:00
PHST- 2014/10/14 06:00 [entrez]
PHST- 2014/10/14 06:00 [pubmed]
PHST- 2014/11/11 06:00 [medline]
PST - ppublish
SO  - Anesteziol Reanimatol. 2014 May-Jun;(3):11-7.