الفهرس 
Remote ischemic preconditioningOnly 14 pages are availabe for public view
 |  | from | 137 |  |  |
| | | from | 137 | | |
Abstract
Cardiac function is crucial for cardiac surgery. Unfortunately, mortality remains very high in patients with poor preoperative cardiac function, long surgical times, complicated or difficult surgical procedures, or incomplete correction of the malformation. It is therefore necessary to find novel approaches to improve cardiac function for cardiac surgery patients in order to simultaneously increase success rates and decrease complications and mortality. When the coronary circulation is interrupted, the size of the resulting infarct is proportional to the duration of ischemia. Paradoxically, even early revascularization leads to tissue damage, a phenomenon known as ischemia reperfusion injury, which is estimated to be responsible for up to 30% of infarct size. This has prompted a search for cytoprotective mechanisms that make the myocardium less vulnerable to such damage, not only in acute settings, but also following surgical procedures that entail temporary interruption of the coronary circulation, particularly cardiac surgery. Inducing non-lethal and brief ischemia before the period of prolonged ischemia has been considered as a tool for increasing the heart‟s resistance to ischemia-reperfusion (I/R) injury. Subsequently, preconditioning the heart with ischemia was shown to maintain its cardio-protective abilities even if the non-lethal ischemic stimulus was applied not directly to the targeted tissue, but to any distant site of the organism – hence the idea of remote ischemic preconditioning (RIPC). In cardiac surgery, where the timing of global ischemia and reperfusion periods is predictable, the application of RIPC seemed a perfect solution. This technique was used in patients for the first time in children undergoing corrective surgery for congenital heart disease, in whom it was shown to reduce troponin release 24h postoperatively.