Remote Ischaemic Preconditioning Does Not Alter Perioperative Cytokine Production in High-risk Cardiac Surgery

Overview

Journal Heart Asia

Date 2016 Jun 22

PMID 27326040

Citations 4

Authors

Jenni M Williams

Paul Young

Janine Pilcher

Mark Weatherall

John Holmes Miller

Richard Beasley

Anne Camille La Flamme

Affiliations

Soon will be listed here.

Abstract

Rationale: Remote ischaemic preconditioning (RIPC) is a novel cardioprotective strategy that uses brief intermittent limb ischaemia to protect the myocardium and other organs from perioperative ischaemic damage. The precise mechanism through which this protective effect occurs is unknown, but potentially could be related to changes in blood-borne mediators such as cytokines.

Objective: To determine whether RIPC alters inflammatory cytokine expression in a double-blind, randomised, controlled trial of patients undergoing high-risk cardiac surgery.

Methods And Results: Serum interleukin (IL)-6, IL-8, and IL-10 levels from 95 patients randomised to RIPC (n=47) or control treatment (n=48) were measured preoperatively, and 1, 2, 3, 6 and 12 h after cross-clamp removal. Systemic concentrations of all cytokines were increased from baseline following surgery, and, compared with simple procedures, complex surgeries were associated with significantly higher release of IL-6 (ratio of mean area under the curves 1.54 (95% CI 1.02 to 2.34), p=0.04) and IL-10 (1.97 (1.16 to 3.35), p=0.012). No significant difference in mean cytokine levels between the RIPC and control groups was detected at any time point, irrespective of the type of surgery undergone.

Conclusions: High levels of IL-6, IL-8 and IL-10 are produced during high-risk cardiac surgery, and RIPC does not alter these elevated perioperative cytokine concentrations. Identification of factors that influence the ability to induce RIPC-mediated cardioprotection should be the priority of future research.

Trial Registration: is in the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12609000965202).

Citing Articles

Effects of interventions targeting the systemic inflammatory response to cardiac surgery on clinical outcomes in adults.

Abbasciano R, Tomassini S, Roman M, Rizzello A, Pathak S, Ramzi J Cochrane Database Syst Rev. 2023; 10:CD013584.

PMID: 37873947 PMC: 10594589. DOI: 10.1002/14651858.CD013584.pub2.

Effect of remote ischemic preconditioning on lung function after surgery under general anesthesia: a systematic review and meta-analysis.

Kashiwagi S, Mihara T, Yokoi A, Yokoyama C, Nakajima D, Goto T Sci Rep. 2023; 13(1):17720.

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Remote ischaemic preconditioning for coronary artery bypass grafting (with or without valve surgery).

Benstoem C, Stoppe C, Liakopoulos O, Ney J, Hasenclever D, Meybohm P Cochrane Database Syst Rev. 2017; 5:CD011719.

PMID: 28475274 PMC: 6481544. DOI: 10.1002/14651858.CD011719.pub3.

Additive Effect on Survival of Anaesthetic Cardiac Protection and Remote Ischemic Preconditioning in Cardiac Surgery: A Bayesian Network Meta-Analysis of Randomized Trials.

Zangrillo A, Musu M, Greco T, Di Prima A, Matteazzi A, Testa V PLoS One. 2015; 10(7):e0134264.

PMID: 26231003 PMC: 4521933. DOI: 10.1371/journal.pone.0134264.

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