Table 1.
Clinical trials to date in remote ischemic preconditioning.
| Year | n | Author | Clinical setting | Conditioning protocol | Results |
|---|---|---|---|---|---|
| 2000 | 8 | Günyaydin | Coronary artery bypass grafting (CABG) | Arm 2 × 3 min | ↑Lactate dehydrogenase (LDH) in preconditioned group |
| 2005 | 12 | Chan | Clipping of cerebral aneurysm following subarachnoid haemorrhage | Proximal artery 2 min catheter occlusion, 30 min reperfusion | ↓tissue hypoxia (slower decline in pO2 and pH) |
| 2006 | 41 | Iliodromitis | Elective single vessel percutaneous coronary intervention (PCI) and stenting | Both arms 3 × 5 min | Increased troponin I, CK-MB, and C-reactive protein (CRP) |
| 2006 | 37 | Cheung | Paediatric surgery for congenital cardiac defects | Leg 4 × 5 min | ↓troponin T, ↓post-op inotrope requirements, ↓airway resistance |
| 2007 | 82 | Ali | Elective open abdominal aortic aneurysm repair | Internal iliac cross-clamp 2 × 10 min | ↓absolute risk of myocardial injury/infarction (troponin I) and renal injury (creatinine) |
| 2007 | 57 | Hausenloy | Elective CABG | Arm 3 × 5 min | ↓troponin T |
| 2008 | 165 | Faries | Balloon occlusion during carotid angioplasty and stenting | Temporary balloon occlusion of ICA | Decreased Glasgow Coma Score (GCS) seen on initial balloon inflation not observed when blood reinflated |
| 2009 | 45 | Venugopal | CABG (cold-blood cardioplegia) +/− valve replacement | Arm 3 × 5 min | ↓troponin T |
| 2009 | 242 | Hoole | Elective PCI | Arm 3 × 5 min | ↓troponin I, reduces ischaemic pain during PCI |
| 2009 | 42 | Hoole | Elective PCI for single vessel coronary artery disease | Arm 3 × 5 min | No effect on left ventricular dysfunction (conductance catheter/Doppler/dobutamine stress echocardiogram) |
| 2009 | 40 | Walsh | Endovascular AAA repair | Both legs 10 min ischaemia | Reduced urinary retinol binding protein and albumin : creatinine ratio |
| 2010 | 70 | Walsh | Carotid endarterectomy | Both legs 10 min ischaemia | Fewer saccadic latency deteriorations (did not reach statistical significance) |
| 2010 | 78 | Venugopal | CABG | Arm 3 × 5 min | Post hoc analysis of 2 previous studies. Decreased Acute Kidney Injury (AKI) on Acute Kidney Injury Network (AKIN) criteria |
| 2010 | 162 | Rahman | CABG (on-pump) | Arm 3 × 5 min | No difference in trop T/cardiac performance/inotrope requirement/echo function/arrthymias/renal or lung outcomes |
| 2010 | 120 | Wagner | CABG with cold crystalloid cardioplegia | Arm 3 × 5 min | ↓troponin I; tramadol administration increased troponin |
| 2010 | 51 | Walsh | Open infrarenal AAA repair | Sequential common iliac clamping | No differences in renal outcomes (urinary retinol binding protein (RBP) and albumin : creatinine ratio (ACR)) |
| 2010 | 60 | Wenwu | Ventricular septal defect repair | Arm 3 × 5 min; 24 h and 1 h before surgery | Reduced cytokines and cardiac enzymes, upregulation of heat shock protein (HSP) 70; improved lung compliance |
| 2010 | 40 | Hu | Elective decompression surgery for adult cervical spondylotic myelopathy | Arm 3 × 5 min | Reduced markers of ischaemic neuronal injury S-100B and neuron-specific enolase; improved recovery rate on functional score |
| 2011 | 120 | Zimmerman | Cardiac surgery with cardiopulmonary bypass | Leg 3 × 5 min | Reduced relative risk of AKI on AKIN criteria |
| 2011 | 113 | Pedersen | Paediatric surgery for correction of complex cardiac defects | Leg 4 × 5 min | No effect on development of AKI, urine output, or urinary biomarkers |
| 2011 | 76 | Choi | Complex valvular heart surgery with CPB | Leg 3 × 5 min | No effect on creatinine, cystatin C, or neutrophil-gelatinase-associated lipocalin (NGAL), estimated glomerular filtration rate Decreased CK-MB at 24 hours |
| 2011 | 242 | Munk | Primary PCI for acute MI | Arm 4 × 5 min, prehospital | Modest improvement in LV systolic function (not significant) |