Introduction: Remote ischemic preconditioning has gained clinicians' attention as a technique to protect the heart in patients undergoing cardiac surgery under cardiopulmonary bypass. While experimental data report neuroprotective properties of remote ischemic preconditioning, we failed to find any clinical studies investigating its effects on neurologic outcome in cardiac surgery.
Purpose of the study: This prospective randomized placebo-controlled study was undertaken with the aim of elucidating the role of remote ischemic preconditioning for neuroprotection in cardiac surgery.
Patients and methods: 88 patients with coronary heart disease scheduled for on-pump coronary bypass grafting surgery were randomized to receive either remote ischemic preconditioning or control. We studied S100B peptide and neuron-specific enolase to assess neurological damage. Psychophysiological tests were employed to investigate cognitive function after surgery.
Results: The perioperative dynamics of S100B and neuron-specific enolase followed similar patterns in both groups throughout the observation period. At the end of surgery, level of S100B was significantly higher in the preconditioning group as compared to controls--0.58 (0.33-0.65) vs. 0.34 (0.23-0.42) mcg/l, p<O. 01). No other significant between-group differences in biochemical markers were observed. No between-group differences in cognitive function and neurologic outcome after surgery were detected.
Conclusion: Our data suggest that remote ischemic preconditioning does not affect neuronal damage and neurologic outcome in patients operated under cardiopulmonary bypass.