The Effects Of Remote Ischemic Preconditioning On Cardiopulmonary Function In Patients Undergoing Coronary Artery Bypass Surgery

Objective:Remote ischemic preconditioning is a powerful endogenous protective phenomenon in the body.It has been applied in many animal and clinical studies at home and abroad,but the cardiopulmonary function of remote ischemic preconditioning for coronary artery bypass graft surgery.The protective effect has rarely been reported.This study is to investigate whether remote ischemic preconditioning can effectively protect cardiopulmonary function in patients undergoing coronary artery bypass surgery.Methods:30 patients undergoing elective coronary artery bypass surgery were randomly divided into two groups using random number table method: a remote ischemic preconditioning group(group R n=30)and a blank control group(group C n=15).In the remote ischemic preconditioning group,after the tracheal intubation,the tourniquet was inflated to the right thigh root to 60 mm Hg,and the right dorsal artery was inaccessible.The toe oxygen saturation could not be measured as the standard,and the right lower limb was performed on the patient.5 minutes ischemia / 5 minutes reperfusion treatment,the above process was repeated 3 times;the control group only tied the tourniquet,not inflated.Preoperative(T0),CPB end(T1),CPB 1 hour(T2),CPB 6 hours(T3),CPB 12 hours(T4),CPB 24 hours(T5)The venous blood was taken 3 m L to measure the levels of myocardial enzyme and troponin I.The echocardiogram(EF)and BNP were reviewed one week after surgery.At the same time,preoperative(T0),6 hours after CPB(T1),and 12 after CPB Hours(T2),24 hours after CPB(T3),arterial blood was taken from the radial artery for blood gas analysis,and the simultaneous inhaled oxygen concentration(Fi O2),oxygen partial pressure(Pa O2),and alveolar-arterial oxygen partial pressure difference were recorded.Calculate oxygen and index(Pa O2/Fi O2)and respiratory index(alveolar-arterial oxygen partial pressure difference/Pa O2);record ventilator assisted ventilation time,operation time,cardiopulmonary bypass(CBP)time,ascending aorta occlusion time,surgery The re-jump situation of the heart,the 24-hour postoperative drainage and urine volume,the second thoracotomy rate,ICU stay time,hospital stay and other indicators.Results: There was no significant difference in the cumulative incidence of c Tn I,CK-MB,oxygen and index(OI),and respiratory index(RI)between the patients in the two groups(P>0.05).There were no significant inter-group differences between the secondary end points of the post-ventilator assisted use time,ICU stay time,24-hour postoperative drainage,postoperative EF values,total hospital stay,postoperative low cardiac output syndrome,postoperative acute liver and renal insufficiency.Conclusions:For the patients undergoing coronary artery bypass surgery under cardiopulmonary bypass in this study,the addition of remote ischemic preconditioning did not significantly improve postoperative cardiopulmonary function and clinical outcomes.