Remote Ischemic Preconditioning for Renal Protection During Elective Open Infrarenal Abdominal Aortic Aneurysm Repair: Randomized Controlled Trial

Vascular and Endovascular Surgery - Tập 44 Số 5 - Trang 334-340 - 2010
Stewart R. Walsh1, Umar Sadat1, Jonathan R. Boyle1, Tjun Yip Tang1, Marta Lapsley2, Anthony G.W. Norden3, M E Gaunt1
1Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust,
2NHS Foundation Trust and South-West Thames Institute for Renal Research Unit, Epsom & St Helier NHS Trust
3Department of Biochemistry, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust

Tóm tắt

We aimed to determine whether remote ischemic preconditioning (IP) reduces renal damage following elective open infrarenal abdominal aortic aneurysm (AAA) repair. Sequential common iliac clamping was used to induce remote IP in randomized patients. Urinary retinol binding protein (RBP) and albumin-creatinine ratio (ACR) were measured following induction and 3, 24, and 48 hours postoperatively. In controls (n = 22), median urinary RBP increased from 112 µg/mL (interquartile range [IQR] 96-173 µg/mL) preoperatively to 5919 µg/mL (IQR 283-17 788 µg/mL) at 3 hours. Preoperative urinary RBP in preconditioned patients was 96 µg/mL (IQR 50 to 229 µg/mL) preoperatively, rising to 1243 µg/mL (IQR 540 to 15400 µg/mL) at 3 hours. Although control patients’ median urinary RBP level was 5 times greater at 3 hours, there were no statistically significant differences in renal outcome indices. This trial could not confirm that remote IP reduces renal injury following elective open aneurysm surgery.

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Tài liệu tham khảo

10.1161/01.CIR.74.5.1124

Ali ZA, 2007, Circulation, 116, 198

10.1093/cvr/cvn114

10.1016/S0140-6736(09)61421-5

10.1016/S0140-6736(07)61296-3

10.1007/s00134-006-0308-1

10.1016/j.ejvs.2006.12.005

10.1016/S1053-0770(98)90106-9

10.1097/00007890-200211150-00009

Song T., 2007, Comp Med, 57, 200

Elsharawy MA, 2000, Ann R Coll Surg Engl, 82, 417

10.1016/j.ejvs.2005.02.009

10.1016/j.ejvs.2005.04.042

10.1159/000180580

10.1002/bjs.4130

10.1016/j.jacc.2006.01.066

10.1583/09-2817.1

10.1016/j.avsg.2008.02.006

10.1177/1538574407299614

10.1016/S0140-6736(08)61236-2

10.1001/archsurg.142.8.733

10.1016/j.jvs.2006.01.017

10.1016/j.jvs.2007.08.054

10.1177/1538574407308942

Walsh SR, Vasc Endovasc Surg

10.1161/CIRCULATIONAHA.108.809723