{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:28:51Z","timestamp":1791253731069,"version":"4.1.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11_suppl_1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,9,14]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            We assessed whether remote ischemic preconditioning (RIPC) improves myocardial, renal, and lung protection after on-pump coronary surgery.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            This was a single-center, prospective, randomized (1:1), placebo-controlled trial. Patients, investigators, anesthetists, surgeons, and critical care teams were blinded to group allocation. Subjects received RIPC (or placebo) stimuli (\u00d73 upper limb (or dummy arm), 5-minute cycles of 200 mm Hg cuff inflation\/deflation) before aortic clamping. Anesthesia, perfusion, cardioplegia, and surgical techniques were standardized. The primary end point was 48-hour area under the curve (AUC) troponin T (cTnT) release. Secondary end points were 6-hour and peak cTnT, ECG changes, cardiac index, inotrope and vasoconstrictor use, renal dysfunction, and lung injury. Hospital survival was 99.4%. Comparing placebo and RIPC, median (interquartile range) AUC 48-hour cTnT (ng\/mL\n            <jats:sup>\u22121<\/jats:sup>\n            \/48 h\n            <jats:sup>\u22121<\/jats:sup>\n            ); 28 (19, 39) versus 30 (22, 38), 6-hour cTnT (ng\/mL\n            <jats:sup>\u22121<\/jats:sup>\n            ); 0.93(0.59, 1.35) versus 1.01(0.72, 1.43), peak cTnT (ng\/mL\n            <jats:sup>\u22121<\/jats:sup>\n            ); 1.02 (0.74, 1.44) versus 1.04 (0.78, 1.51), de novo left bundle-branch block (4% versus 0%) and Q waves (5.3% versus 5.5%), serial cardiac indices, intraaortic balloon pump usage (8.5% versus 7.5%), inotrope (39% versus 50%) and vasoconstrictor usage (66% versus 64%) were not different. Dialysis requirement (1.2% versus 3.8%), peak creatinine (median [interquartile range], 1.2 mg\/dL\n            <jats:sup>\u22121<\/jats:sup>\n            (1.1, 1.4) versus 1.2 (1.0, 1.4)), and AUC urinary albumin-creatinine ratios 69 (40, 112) versus 58 (32, 85) were not different. Intubation times; median (interquartile range), 937 minutes(766, 1402) versus 895(675, 1180), 6-hour; 278 (210, 338) versus 270 (218, 323) and 12-hour pO\n            <jats:sub>2<\/jats:sub>\n            :FiO\n            <jats:sub>2<\/jats:sub>\n            ratios 255 (195, 323) versus 263 (210, 308) were similar.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            In contrast to prior smaller studies, RIPC did not reduce troponin release, improve hemodynamics, or enhance renal or lung protection.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Clinical Trial Registration\u2014<\/jats:italic>\n            <\/jats:bold>\n            URL: http:\/\/www.ukcrn.org.uk. Unique identifier: 4659.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.109.926667","type":"journal-article","created":{"date-parts":[[2010,9,13]],"date-time":"2010-09-13T21:03:47Z","timestamp":1284411827000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":189,"title":["Remote Ischemic Preconditioning in Human Coronary Artery Bypass Surgery"],"prefix":"10.1161","volume":"122","author":[{"given":"Ishtiaq A.","family":"Rahman","sequence":"first","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge G.","family":"Mascaro","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick P.","family":"Steeds","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Frenneaux","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nightingale","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gosling","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Townsend","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N.","family":"Townend","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Green","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Bonser","sequence":"additional","affiliation":[{"name":"From the Department of Cardiothoracic Surgery (I.A.R., J.G.M., R.S.B.) and Department of Cardiology (R.P.S., J.N.T.), University Hospital Birmingham NHS Trust, Birmingham, United Kingdom; the Department of Cardiovascular Medicine (M.P.F., R.S.B.), University of Birmingham, Birmingham, United Kingdom; Wellcome Trust Clinical Research Facility (P.N.), Birmingham, United Kingdom; and the Department of Clinical Biochemistry (P.G.) and Department of Anesthetics (P.T., D.G.), University Hospital..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.02.014"},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61421-5"},{"key":"e_1_3_3_3_2","unstructured":"Hearse DJ Braimbridge MV Jynge P. 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