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M\u00f8ller Fonden","award":["21.557"],"award-info":[{"award-number":["21.557"]}]},{"name":"A.P. M\u00f8ller Fonden","award":["62786"],"award-info":[{"award-number":["62786"]}]},{"name":"A.P. M\u00f8ller Fonden","award":["8051998000"],"award-info":[{"award-number":["8051998000"]}]},{"name":"A.P. M\u00f8ller Fonden","award":["A322"],"award-info":[{"award-number":["A322"]}]},{"name":"A.P. M\u00f8ller Fonden","award":["L-2021-00050"],"award-info":[{"award-number":["L-2021-00050"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Endothelial dysfunction result from inflammation and excessive production of reactive oxygen species as part of the surgical stress response. Remote ischemic preconditioning (RIPC) potentially exerts anti-oxidative and anti-inflammatory properties, which might stabilise the endothelial function after non-cardiac surgery. This was a single centre randomised clinical trial including 60 patients undergoing sub-acute laparoscopic cholecystectomy due to acute cholecystitis. Patients were randomised to RIPC or control. The RIPC procedure consisted of four cycles of five minutes of ischaemia and reperfusion of one upper extremity. Endothelial function was assessed as the reactive hyperaemia index (RHI) and circulating biomarkers of nitric oxide (NO) bioavailability (L-arginine, asymmetric dimethylarginine (ADMA), L-arginine\/ADMA ratio, tetra- and dihydrobiopterin (BH4 and BH2), and total plasma biopterin) preoperative, 2\u20134 h after surgery and 24 h after surgery. RHI did not differ between the groups (p = 0.07). Neither did levels of circulating biomarkers of NO bioavailability change in response to RIPC. L-arginine and L-arginine\/ADMA ratio was suppressed preoperatively and increased 24 h after surgery (p &lt; 0.001). The BH4\/BH2-ratio had a high preoperative level, decreased 2\u20134 h after surgery and remained low 24 h after surgery (p = 0.01). RIPC did not influence endothelial function or markers of NO bioavailability until 24 h after sub-acute laparoscopic cholecystectomy. In response to surgery, markers of NO bioavailability increased, and oxidative stress decreased. These findings support that a minimally invasive removal of the inflamed gallbladder countereffects reduced markers of NO bioavailability and increased oxidative stress caused by acute cholecystitis.<\/jats:p>","DOI":"10.3390\/cells12060911","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T03:50:45Z","timestamp":1678938645000},"page":"911","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Remote Ischaemic Preconditioning on Perioperative Endothelial Dysfunction in Non-Cardiac Surgery: A Randomised Clinical Trial"],"prefix":"10.3390","volume":"12","author":[{"given":"Kirsten L.","family":"Wahlstr\u00f8m","sequence":"first","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkeb\u00e6kvej 1, 4600 K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah F.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkeb\u00e6kvej 1, 4600 K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-2771","authenticated-orcid":false,"given":"Madeline","family":"Kvist","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkeb\u00e6kvej 1, 4600 K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Burcharth","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkeb\u00e6kvej 1, 4600 K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6514-8407","authenticated-orcid":false,"given":"Jens","family":"Lykkesfeldt","sequence":"additional","affiliation":[{"name":"Section of Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Ridebanevej 9, 1871 Frederiksberg C, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"G\u00f6genur","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkeb\u00e6kvej 1, 4600 K\u00f8ge, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ekeloef","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkeb\u00e6kvej 1, 4600 K\u00f8ge, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.surg.2011.07.021","article-title":"Rates and patterns of death after surgery in the United States, 1996 and 2006","volume":"151","author":"Semel","year":"2012","journal-title":"Surgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1503\/cmaj.050011","article-title":"Perioperative cardiac events in patients undergoing noncardiac surgery: A review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk","volume":"173","author":"Devereaux","year":"2005","journal-title":"CMAJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/bja\/85.1.109","article-title":"The stress response to trauma and surgery","volume":"85","author":"Desborough","year":"2000","journal-title":"Br. 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