Remote Ischaemic Preconditioning for Heart Surgery (RIPHeart-Study)

• Applicant: Professor Dr. Patrick Meybohm
• Subject Area: Anaesthesiology
• Term: from 2010 to 2014
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 129494800

Cardiac surgery is associated with a predictable incidence of myocardial, neurological and renal dysfunction that account for significant perioperative morbidity and mortality. Transient ischaemia of nonvital tissue has been shown to enhance the tolerance of remote organs to cope with a subsequent prolonged ischaemic event in a number of clinical situations, a phenomenon known as remote ischaemic preconditioning. We hypothesise that remote ischaemic preconditioning improves patient’s outcome after surgery compared to no active intervention. We conduct a prospective, randomised, double-blind, multicentre, controlled trial including 2070 patients undergoing cardiac surgery in which cardiopulmonary bypass is used. Patients will be randomized either to the remote ischaemic preconditioning group receiving four cycles of transient upper limb ischaemia/reperfusion using a blood-pressure cuff inflated to a pressure 15 mm Hg higher than the systolic arterial pressure after induction of anaesthesia, or to the control group receiving four cycles of transient upper limb ‘pseudo’-inflation/deflation to a pressure of 20 mm Hg. Primary endpoint is a composite outcome (all-cause mortality, non-fatal myocardial infarction, any new stroke, and/or acute renal failure) within 30 days after surgery. Secondary endpoints are any component of the composite endpoint within 1 year after surgery, length of hospital stay, myocardial damage, myocardial function (echocardiography), new onset of a trial fibrillation, neurocognitive function test, and acute kidney injury.

• DFG Programme: Clinical Trials
• Participating Persons: Professor Dr. Berthold Bein; Professor Dr. Joachim Cremer; Professor Kai Zacharowski, Ph.D.