Table 2.
Clinical RCTs of RIC and cytokine release (2015–20)
| Authors | Study design | Participants | Method of RIC | Inflammatory findings |
|---|---|---|---|---|
|
Godskesen et al. |
Randomised, single-blinded, sham- controlled trial | Patients with ulcerative colitis and moderate disease activity underwent 10 days of RIC vs sham controls (n = 22) | 4 alternating cycles of 200 mmHg arm blood pressure cuff inflation and deflation (5/5 min) |
No significant differences observed in plasma cytokine levels between groups (p > 0.05) No significant differences observed in neutrophil infiltration on rectal biopsy (p = 0.85) No significant differences observed in plasma CRP levels (p = 0.63) |
|
Oh et al. KCT001384 [108] |
Randomised, double-blinded control trial | Patients undergoing RIC prior to shoulder surgery in the beach chair position (cerebral hypo perfusion) vs controls (n = 63) | 3 alternating cycles of thigh blood pressure cuff inflation (to 2 × baseline BP value) and deflation (5/2 min) |
RIC increased cerebral oxygen saturations during surgery (p = 0.007) No significant differences observed in levels of IL-1β, IL-6, IL-10 and transforming growth factor |
|
Wang et al. |
Randomised, single-blinded control trial | Patients with IHD undergoing RIC prior to off-pump CABG vs controls (n = 65) | 4 cycles UL ischaemia with inflation (to 40 mmHg greater than baseline BP) and deflation (5/5 min) |
RIC significantly reduced plasma levels of troponin T (p < 0.05) RIC significantly reduced levels of IL-6, IL-8 and TNF-α (p < 0.05) and increased levels of HIF-1α (p < 0.05) |
|
Zwaag et al. |
Randomised, single-centre control trial | Healthy male volunteers undergoing RIC for 6 days + RIC 40 min prior to LPS challenge vs RIC 40 min before LPS alone vs controls receiving LPS (n = 30) | 4 cycles of UL ischaemia with cuff inflation to 250 mmHg and deflation (5/5 min) | No significant differences observed in levels of TNF-α, IL-6, IL-8 and MCP-1 (p > 0.10) |
| Zapata-Chavira et al. [149] | Randomised, control trial | Patients with CKD undergoing RIC prior to heterotopic renal transplant vs controls (n = 29) | Bilateral thigh cuff inflation to 200 mmHg (10 min) | Significantly higher levels of TNF-α and IL-6 in the RIC group (p < 0.05) |
|
Ney et al. Sub-analysis of NCT01067703 RIPheart [106] |
Randomised, double-blind, multi-centre control trial (sub-analysis) | Patients with IHD undergoing RIC prior to CABG with propofol anaesthesia vs controls (n = 40) | 4 cycles of UL ischaemia with cuff inflation to 200 mmHg (or > 15 mmHg higher than baseline whichever greater) and deflation (5/5 min) | No significant differences observed in post-operative troponin levels or cytokine levels (p > 0.05) |
|
Nederlof et al. NTR2915 [105] |
Randomised, double-blind single-centre control trial | Male patients with IHD undergoing RIC prior to CABG with sevoflurane anaesthesia vs controls (n = 29) | 3 cycles of UL ischaemia with cuff inflation to 200 mmHg and deflation (5 min) |
No significant difference in CtnT levels at 24 h (p = 0.76) between groups No significant differences observed in levels of cytokines before and after RIC (p > 0.05) |
|
Gedik et al. |
Randomised, double-blind control trial (sub-analysis) | Patients with IHD undergoing RIC prior to CABG with sufentanil anaesthesia vs controls (n = 46) | 3 cycles of UL ischaemia with cuff inflation and deflation (5/5 min) |
RIC reduced troponin levels at 72 h post-op (p < 0.05) Significantly higher levels of IL-1α in the RIC group (p < 0.05), no differences observed in other pro-inflammatory cytokines (p > 0.05) |
| He et al. [53] | Randomised, double-blind, control trial | Patients 65–75 years undergoing RIC prior to elective colorectal surgery vs controls (n = 90) | 3 cycles of UL ischaemia with cuff inflation to 200 mmHg (5/5 min) | RIC significantly reduced plasma concentrations of IL-1β, TNF-α up to 3 days post-surgery (p < 0.001) |