Effect of Remote Ischemic Preconditioning on Lung Injury After Pulmonary Resection

Study Overview
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Brief Summary
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The purpose of this study is to determine whether ischemic preconditioning reduces lung injury in patients undergoing pulmonary resection.

Detailed Description
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Remote ischemic preconditioning is an intervention in which brief ischemia of one tissue or organ protects remote organs from a sustained episode of ischemia. It is known that one-lung ventilation in patients undergoing pulmonary resection, which may cause acute lung injury. The investigators did a single-blinded randomised controlled study to establish whether remote ischemic preconditioning reduces lung injury in these patients.

Official Title
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Effect of Remote Ischemic Preconditioning on Lung Injury in Patients Undergoing Pulmonary Resection:a Randomised Controlled Trial

Conditions
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Lung Neoplasms

Intervention / Treatment
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* Procedure: remote ischemic preconditioning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of pulmonary carcinoma Must be received pulmonary lobectomy Exclusion Criteria: Cardiac disease categorized as NYHA classes II-IV Preoperative severe impairment of respiratory function (arterial oxygen tension (PaO2) <60 mmHg or FEV1<50% predicted), Pre-existing coagulopathy or thrombocytopenia Prior receipt of chemotherapy or radiation therapy or immunotherapy Systemic or local active infections (either clinically defined or suggested by evidence such as elevated C-reactive protein levels, leukocytosis, or a body temperature>38℃) Peripheral vascular disease affecting the upper limbs Administration of vitamins, nonsteroidal anti-inflammatory agent or corticosteroid within 3 months.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: preconditioning<br>Adult patients undergoing elective pulmonary lobectomy were received a remote ischemic preconditioning group after induction of anaesthesia. | Procedure: remote ischemic preconditioning<br>* Remote ischaemic preconditioning consisted of three 5-min cycles of right upper limb ischaemia, induced by an automated cuff-inflator placed on the upper arm and inflated to 200 mm Hg, with an intervening 5 min of reperfusion during which the cuff was deflated.<br>* Other names: RIP;|
| No Intervention: conventional<br>Adult patients undergoing pulmonary lobectomy were received no treatment after induction of anaesthesia. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Limb remote ischemic preconditioning has effective protection of lung injury in patients undergoing pulmonary lobectomy | PaO2/FiO2 in the limb RIPC group was significantly higher than that in the control group at 30 and 60 min after OLV, 30 min and 6 h after operation (all P<0.05) | June,2013 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cs and Cd | Cs and Cd in limb RIPC group were significantly higher than those in the control group at 30 and 60 min after OLV (all P<0.05) | June,2013 | 
| IL-6 and TNF-α | The IL-6 levels in the limb RIPC group were lower than those in the control group at 30 min, 6, 12, 24 and 48 h after operation (all P<0.05), and there was a significant difference in TNF-α level between the groups (P<0.01). | June,2013 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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remote ischemic preconditioning, lung injury, pulmonary resection