Remote ischemic preconditioning improves tissue oxygenation in a porcine model of controlled hemorrhage without fluid resuscitation.

Autor:	Yaniv G; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel., Eisenkraft A; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel. aizenkra@gmail.com., Gavish L; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; The Saul and Joyce Brandman Hub for Cardiovascular Research and the Department of Medical Neurobiology, Institute for Medical Research (IMRIC), Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel., Wagnert-Avraham L; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel., Nachman D; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel., Megreli J; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Shimon G; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Rimbrot D; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Simon B; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Berman A; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Cohen M; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Kushnir D; Center for Innovative Surgery, Hadassah Medical Center, Jerusalem, Israel., Shaylor R; Division of Anesthesiology and Intensive Care, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel., Batzofin B; The Department of Anesthesiology, Hadassah Medical Center, Jerusalem, Israel., Firman S; The Department of Anesthesiology, Hadassah Medical Center, Jerusalem, Israel., Shlaifer A; Israel Defense Forces Medical Corps, Jerusalem, Israel., Hartal M; The Myers-JDC-Brookdale Institute, Jerusalem, Israel., Heled Y; Israel Defense Forces Medical Corps, Jerusalem, Israel., Glassberg E; Israel Defense Forces Medical Corps, Jerusalem, Israel.; The Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel., Kreiss Y; Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.; Israel Defense Forces Medical Corps, Jerusalem, Israel., Gertz SD; Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, POB 12272, 91120, Jerusalem, Israel.; The Saul and Joyce Brandman Hub for Cardiovascular Research and the Department of Medical Neurobiology, Institute for Medical Research (IMRIC), Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Jazyk:	angličtina
Zdroj:	Scientific reports [Sci Rep] 2021 May 24; Vol. 11 (1), pp. 10808. Date of Electronic Publication: 2021 May 24.
DOI:	10.1038/s41598-021-90470-6
Abstrakt:	Remote ischemic preconditioning (RIPC) involves deliberate, brief interruptions of blood flow to increase the tolerance of distant critical organs to ischemia. This study tests the effects of limb RIPC in a porcine model of controlled hemorrhage without replacement therapy simulating an extreme field situation of delayed evacuation to definitive care. Twenty-eight pigs (47 ± 6 kg) were assigned to: (1) control, no procedure (n = 7); (2) HS = hemorrhagic shock (n = 13); and (3) RIPC + HS = remote ischemic preconditioning followed by hemorrhage (n = 8). The animals were observed for 7 h after bleeding without fluid replacement. Survival rate between animals of the RIPC + HS group and those of the HS group were similar (HS, 6 of 13[46%]-vs-RIPC + HS, 4 of 8[50%], p = 0.86 by Chi-square). Animals of the RIPC + HS group had faster recovery of mean arterial pressure and developed higher heart rates without complications. They also had less decrease in pH and bicarbonate, and the increase in lactate began later. Global oxygen delivery was higher, and tissue oxygen extraction ratio lower, in RIPC + HS animals. These improvements after RIPC in hemodynamic and metabolic status provide essential substrates for improved cellular response after hemorrhage and reduction of the likelihood of potentially catastrophic consequences of the accompanying ischemia.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF