Ischemia Preconditioning Helps Children in Heart Surgery

Postoperative myocardial damage indicators lower in children randomized to preconditioning

WEDNESDAY, June 14 (HealthDay News) -- Preconditioning children about to undergo cardiac surgery by temporarily blocking blood flow to their legs and inducing ischemia-reperfusion may offer a protective effect against ischemia-related damage during the procedure, according to a report in the June 6 issue of the Journal of the American College of Cardiology.

Andrew Redington, M.D., F.R.C.P., from the Hospital for Sick Children in Toronto, Ontario, and colleagues conducted a randomized controlled trial of the effects of remote ischemic preconditioning (RIPC) in 37 children undergoing repair of congenital heart defects. RIPC was conducted in 17 children by inducing ischemia in the leg in four 5-minute cycles using a blood pressure cuff.

Levels of troponin I and inotropic requirement were greater in the 20 control subjects postoperatively, suggesting these children experienced greater myocardial injury. The RIPC group also had lower airway resistance six hours after surgery.

"This study demonstrates the myocardial protective effects of RIPC using a simple non-invasive technique of four 5-minute cycles of lower limb ischemia and reperfusion," the authors conclude. "These novel data support the need for a larger study of RIPC in patients undergoing cardiac surgery."

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