Limb Remote Ischemic Preconditioning Reduces Heart and Lung Injury After Abdominal Aortic Aneurysm Repair

Remote ischaemic preconditioning may confer the cytoprotection in critical organs. We hypothesized that limb remote ischemic preconditioning (RIPC) would reduce intestinal and pulmonary injury in patients undergoing open infrarenal abdominal aortic aneurysm (AAA) repair.The primary outcomes included the biomarkers reflecting intestinal injury (serum intestinal fatty acid binding protein, endotoxin levels and diamine oxidase activity) and the variables reflecting pulmonary injury (arterial-alveolar oxygen tension ratio, alveolar-arterial oxygen tension difference and respiratory index). In addition, the severity of intestinal and pulmonary injury was assessed with different scoring methods, respectively. Markers of oxidative stress and systemic inflammation were measured as well.

Inclusion criteria

• Clinical diagnosis of abdominal aortic aneurysm
• Must be received open abdominal aortic aneurysm repair

Exclusion criteria

• age >80 years old
• Acute coronary syndrome or myocardial infraction within
• 3 months
• Chronic obstructive pulmonary emphysema
• angina pain within 48 hours of repair procedure
• ejection fraction less than 40%
• poor pulmonary function (PaO2 <60mmHg)
• history of inflammatory bowel disease
• history of diarrhea (≥2 liquid stools per day for ≥2 days) within 1 week of surgery
• intestinal chronic inflammatory disease