| Background: Patients who underwent cardiac surgery,complication like myocardial infarction,renal failure and even death which always threatened the life of patients.Many scholars and clinical workers are searching for a safe and effective strategy for decades to protect patients from the application of cardiopulmonary bypass(CPB)after ischemia/reperfusion(I/R)injury.RIPC provides inflation/deflation circulation to remote organs(limbs)to protect heart and kidney from following I/R injury.The aim is to investigate the cardiac and renal outcomes,in the light of different RIPC regimens,underwent cardiac surgery with CPB.Methods: Collecting 60 cases who underwent elective cardiac surgery under general anesthesia from the first affiliated hospital of Xinjiang medical university,then randomly divided into the upper limb ischemic preconditioning group(URIPC),the lower limb ischemic preconditioning group(LRIPC)and control group(C).Collecting and analyzing serum creatinine,myohemoglobin,troponin I and creatine phosphokinase isoenzyme(CK-MB)of continuous seven days postsurgery,and postoperative left ventricular ejection fraction(LVEF),hospital/ICU(intensive care unit)stay,and mechanical ventilation duration,to explore the cardio-renal protection of different RIPC methods.Result: This study found that myoglobin(P< 0.001)at different timepoints(the first,third,fifth and seventh days after operation)was observed significant difference among patients of three group who underwent cardiac surgery.There was no significant difference in myoglobin(P=0.022)and troponin I(P=0.364)levels among the three groups.However,there was a significant difference in CK-MB level before and after cardiac surgery in group C(P=0.012)and group URIPC(P=0.004).A significant difference was observed in serum creatinine level among the three groups(P=0.024).RIPC significantly shortened the duration of mechanical ventilation(P=0.001),length of hospital stay(P=0.001)and length of ICU stay(P=0.021).However,other outcomes such as troponin I,CK-MB among three groups after surgery and mortality were not statistical different.Conclusion: RIPC fails to protect cardiac and renal function after cardiac surgery under CPB.The better cardioprotective effect(myoglobin and CK-MB)was seen in LRIPC,comparing with URIPC,which might be a false positive result that caused by local ischemic tissue damage.Multiple factors can affect the cardioprotective effect of RIPC,and it should combine the clinical outcomes and monitoring indicators to evaluate the cardioprotective effect of RIPC.Therefore,further optimizing of RIPC regimen are needed to explore the protective role of RIPC. |
