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The magic of remote ischaemic preconditioning

Summary by: Paul Young

2016 is the 30th anniversary of ischaemic preconditioning. Remote ischaemic preconditioning is the magical offspring of ischaemic preconditioning and refers to the phenomenon whereby brief periods of ischaemia in one organ can protect other organs from subsequent prolonged ischaemic insults. In theory, remote ischaemic preconditioning can be induced by temporarily interrupting the blood supply to an extremity using a blood pressure cuff. In experimental models this technique is effective in reducing ischaemia / reperfusion injury when applied after ischaemia but before reperfusion. As a result the technique has a wide range of potential clinical implications including: 1. Heart surgery with cardiopulmonary bypass 2. Planned percutaneous coronary interventions 3. Acute myocardial infarction 4. CBA being treated with lysis or clot retrieval 5. Carotid endarterectomy surgery 6. Hypoxic ischaemic encephalopathy 7. Organ transplantation 8. abdominal aortic aneurysm surgery While this technique is not yet ready for clinical application, it remains an exciting potential therapeutic modality for the future.


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