Abdominal Aortic Aneurysm
Conditions
Keywords
aortic aneurysm, ischemia/reperfusion, preconditioning, pulmonary injury, intestinal injury
Brief summary
To investigate whether limb remote ischemic preconditioning (LRIP) has protective effects against intestinal and pulmonary injury in patients undergoing open infrarenal abdominal aortic aneurysm (AAA) repair.
Detailed description
Remote ischaemic preconditioning may confer the cytoprotection in critical organs. We hypothesized that limb remote ischemic preconditioning (RIPC) would reduce intestinal and pulmonary injury in patients undergoing open infrarenal abdominal aortic aneurysm (AAA) repair.The primary outcomes included the biomarkers reflecting intestinal injury (serum intestinal fatty acid binding protein, endotoxin levels and diamine oxidase activity) and the variables reflecting pulmonary injury (arterial-alveolar oxygen tension ratio, alveolar-arterial oxygen tension difference and respiratory index). In addition, the severity of intestinal and pulmonary injury was assessed with different scoring methods, respectively. Markers of oxidative stress and systemic inflammation were measured as well.
Interventions
LRIP consisted of three cycles of left upper limb ischemia induced by inflating a blood pressure cuff on the left upper arm to 200mmHg, with an intervening 5 minutes of reperfusion, during which time the cuff was deflated.
Sponsors
Cai Li
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of abdominal aortic aneurysm * Must be received open abdominal aortic aneurysm repair
Exclusion criteria
* age \>80 years old * Acute coronary syndrome or myocardial infraction within * 3 months * Chronic obstructive pulmonary emphysema * angina pain within 48 hours of repair procedure * ejection fraction less than 40% * poor pulmonary function (PaO2 \<60mmHg) * history of inflammatory bowel disease * history of diarrhea (≥2 liquid stools per day for ≥2 days) within 1 week of surgery * intestinal chronic inflammatory disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Limb remote ischemic preconditioning has effective protection of lung injury in patients undergoing elective open abdominal aortic aneurysm repair | June,2011 | Compared with the control group, patients in the LRIP group had significantly higher Cs and Cd , along with lower PA-aDO2 and RI at various phase (P\<0.05). Serum concentration of IL-6,IL-8, TNF-ɑ and MDA in LRIP group were decreased significantly at postoperative time points compared with those in control group (P\<0.05), but SOD was increased significantly at the same time (P\<0.05). Patient's ventilator support time and duration of ICU stay in LRIP group were shorter than that in control group (P\<0.05) |
Outcome results
None listed