Acute effects of remote ischemic preconditioning on cutaneous microcirculation - a controlled prospective cohort study

BMC Surgery

Research Article

Johan Lorenzen¹  Peter M Vogt²  Christian Herold²  Marc Busche²  Robert Kraemer²  Karsten Knobloch²  Mohammad Kabbani² 

[1] Department of Nephrology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany;Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany;

关键词: Remote ischemic preconditioning;    cutaneous microcirculation;    free flap;    soft tissue;   

DOI  :  10.1186/1471-2482-11-32

 received in 2011-04-05, accepted in 2011-11-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundTherapeutic strategies aiming to reduce ischemia/reperfusion injury by conditioning tissue tolerance against ischemia appear attractive not only from a scientific perspective, but also in clinics. Although previous studies indicate that remote ischemic intermittent preconditioning (RIPC) is a systemic phenomenon, only a few studies have focused on the elucidation of its mechanisms of action especially in the clinical setting. Therefore, the aim of this study is to evaluate the acute microcirculatory effects of remote ischemic preconditioning on a distinct cutaneous location at the lower extremity which is typically used as a harvesting site for free flap reconstructive surgery in a human in-vivo setting.MethodsMicrocirculatory data of 27 healthy subjects (25 males, age 24 ± 4 years, BMI 23.3) were evaluated continuously at the anterolateral aspect of the left thigh during RIPC using combined Laser-Doppler and photospectrometry (Oxygen-to-see, Lea Medizintechnik, Germany). After baseline microcirculatory measurement, remote ischemia was induced using a tourniquet on the contralateral upper arm for three cycles of 5 min.ResultsAfter RIPC, tissue oxygen saturation and capillary blood flow increased up to 29% and 35% during the third reperfusion phase versus baseline measurement, respectively (both p = 0.001). Postcapillary venous filling pressure decreased statistically significant by 16% during second reperfusion phase (p = 0.028).ConclusionRemote intermittent ischemic preconditioning affects cutaneous tissue oxygen saturation, arterial capillary blood flow and postcapillary venous filling pressure at a remote cutaneous location of the lower extremity. To what extent remote preconditioning might ameliorate reperfusion injury in soft tissue trauma or free flap transplantation further clinical trials have to evaluate.Trial registrationClinicalTrials.gov: NCT01235286

【 授权许可】

CC BY   
© Kraemer et al; licensee BioMed Central Ltd. 2011