Renal and hepatic protection due to remote ischemic conditioning in coronary artery bypass grafting

Authors

  • Rudy Hernández Ortega Cardiocentro Hermanos Ameijeiras http://orcid.org/0000-0002-7306-0018
  • Osvaldo González Alfonso
  • Antonio J. Cabrera Pratts
  • Raúl Cruz Boza
  • Juliette M. Suárez López
  • Gilberto Bulies de Armas
  • Yahima Sánchez Hernández

Abstract

Introduction: Short periods of distant ischemia can limit myocardial damage caused by ischemia/reperfusion.

Objectives: To identify the effect of remote ischemic preconditioning in relation to the postoperative behavior of creatinine, glutamic transaminase, puruvic and oxalacetic levels.

Method: A quasi-experimental, explanatory, comparative study with historical control was carried out in two groups of 247 patients each; all candidates for coronary artery bypass grafting. A blood-pressure cuff was placed on the right arm in the study group alternating three inflations with three deflations of five minutes at 200 mmHg. This procedure was performed prior to during and after the major ischemic episode caused by the coronary artery impingement.

Results: A significant decrease in the values of creatinine, puruvic glutamic transaminase and glutamic oxalacetic transaminase was achieved.

Conclusions: Remote ischemic conditioning is an important tool to take into account for renal and hepatic protection in coronary artery bypass grafting.

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Author Biography

Rudy Hernández Ortega, Cardiocentro Hermanos Ameijeiras

Doctor en Ciencias Médicas, especialista de 1er y 2do grado en Anestesiología y Reanimación, profesor Auxiliar

References

1. Llapur Milián R, González Sánchez R. La enfermedad cardiovascular aterosclerótica desde la niñez a la adultez. Rev Cubana Pediatr [Internet]. 2017 [citado 26 Dic 2018];89(3):271-7. Disponible en: http://www.revpediatria.sld.cu/index.php/ped/article/view/389/130

2. Carrasco Chinchilla F. Postcondicionamiento isquémico a distancia en la angioplastia coronaria [Tesis]. España: Universidad de Málaga [Internet]; 2014 [citado 10 Ene 2019]. Disponible en: https://riuma.uma.es/xmlui/handle/10630/7873

3. Ministerio de Salud Pública. Anuario Estadístico de Salud 2017. La Habana: Dirección Nacional de Registros Médicos y Estadísticas de Salud; 2018.

4. Mitchell RN, Kumar V, Abbas AK, Aster JC. Compendio de Robbins y Cotran. Patología estructural y funcional. 9ª ed. Barcelona: Elsevier; 2017.

5. Balakumar P, Sharma NK. Healing the diabetic heart: does myocardial preconditioning work? Cell Signal. 2012;24(1):53-9.

6. Hensley FA, Martin DE, Gravlee GP. Anestesia cardíaca. 1ª ed. Madrid: Marbán; 2004.

7. Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation. 1986;74(5):1124-36.

8. Przyklenk K, Bauer B, Ovize M, Kloner RA, Whittaker P. Regional ischemic 'preconditioning' protects remote virgin myocardium from subsequent sustained coronary occlusion. Circulation. 1993;87(3):893-9.

9. Jankauskas SS, Pevzner IB, Andrianova NV, Zorova LD, Popkov VA, Silachev DN, et al. The age-associated loss of ischemic preconditioning in the kidney is accompanied by mitochondrial dysfunction, increased protein acetylation and decreased autophagy. Sci Rep [Internet]. 2017 [citado 12 Ene 2019];7:44430. Disponible en: https://www.nature.com/articles/srep44430

10. Veighey K, Macallister RJ. Clinical applications of remote ischemic preconditioning. Cardiol Res Pract [Internet]. 2012 [citado 12 Ene 2019];2012:620681. Disponible en: http://downloads.hindawi.com/journals/crp/2012/620681.pdf

11. Candilio L, Hausenloy D. Is there a role for ischaemic conditioning in cardiac surgery? F1000Research [Internet]. 2017 [citado 14 Ene 2019];6:563. Disponible en: https://doi.org/10.12688/f1000research.10963.1

12. Zhou C, Bulluck H, Fang N, Li L, Hausenloy DJ. Age and surgical complexity impact on renoprotection by remote ischemic preconditioning during adult cardiac surgery: a meta-analysis. Sci Rep [Internet]. 2017 [citado 14 Ene 2019];7:215. Disponible en: https://www.nature.com/articles/s41598-017-00308-3.pdf

13. Zhou CC, Ge YZ, Yao WT, Wu R, Xin H, Lu TZ, et al. Limited clinical utility of remote ischemic conditioning in renal transplantation: a meta-analysis of randomized controlled trials. PLoS One [Internet]. 2017 [citado 14 Ene 2019];12(1):e0170729. Disponible en: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170729

14. Alreja G, Bugano D, Lotfi A. Effect of remote ischemic preconditioning on myocardial and renal injury: meta-analysis of randomized controlled trials. J Invasive Cardiol. 2012;24(2):42-8.

15. Zhang M, Yang D, Gong X, Ge P, Dai J, Lin L, et al. Protective benefits of AMP-activated protein kinase in hepatic ischemia-reperfusion injury. Am J Transl Res [Internet]. 2017 [citado 14 Ene 2019];9(3):823-9. Disponible en: http://www.ajtr.org/files/ajtr0045806.pdf

16. Walsh SR, Boyle JR, Tang TY, Sadat U, Cooper DG, Lapsley M, Norden AG, et al. Remote ischemic preconditioning for renal and cardiac protection during endovascular aneurysm repair: a randomized controlled trial. J Endovasc Ther. 2009;16(6):680-9.

17. Walsh SR, Sadat U, Boyle JR, Tang TY, Lapsley M, Norden AG, et al. Remote ischemic preconditioning for renal protection during elective open infrarenal abdominal aortic aneurysm repair: randomized controlled trial. Vasc Endovascular Surg. 2010;44(5):334-40.

18. Pedersen KR, Ravn HB, Povlsen JV, Schmidt MR, Erlandsen EJ, Hjortdal VE. Failure of remote ischemic preconditioning to reduce the risk of postoperative acute kidney injury in children undergoing operation for complex congenital heart disease: a randomized single-center study. J Thorac Cardiovasc Surg. 2012;143(3):576-83.

19. Kunst G. From coronary steal to myocardial, renal, and cerebral protection: more questions than answers in anaesthetic preconditioning? Br J Anaesth. 2014;112(6):958-60.

20. Walsh SR, Nouraei SA, Tang TY, Sadat U, Carpenter RH, Gaunt ME. Remote ischemic preconditioning for cerebral and cardiac protection during carotid endarterectomy: results from a pilot randomized clinical trial. Vasc Endovascular Surg. 2010;44(6):434-9.

21. Oh CS, Kim SH, Lee J, Rhee KY. Impact of remote ischaemic preconditioning on cerebral oxygenation during total knee arthroplasty. Int J Med Sci [Internet]. 2017 [citado 16 Ene 2019];14(2):115-22. Disponible en: http://www.medsci.org/v14p0115.pdf

22. Zimmerman RF, Ezeanuna PU, Kane JC, Cleland CD, Kempananjappa TJ, Lucas FL, et al. Ischemic preconditioning at a remote site prevents acute kidney injury in patients following cardiac surgery. Kidney Int. 2011;80(8):861-7.

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Published

2019-04-06

How to Cite

1.
Hernández Ortega R, González Alfonso O, Cabrera Pratts AJ, Cruz Boza R, Suárez López JM, Bulies de Armas G, et al. Renal and hepatic protection due to remote ischemic conditioning in coronary artery bypass grafting. CorSalud [Internet]. 2019 Apr. 6 [cited 2025 Jul. 2];11(2):139-45. Available from: https://revcorsalud.sld.cu/index.php/cors/article/view/383

Issue

Vol. 11 No. 2 (2019)

Section

BRIEF ARTICLES

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