Remote ischemic precondition preserves cerebral oxygen tension during hypothermic circulatory arrest

Abstract

Objectives. Remote ischemic preconditioning (RIPC) is a novel and promising method of mitigating neurological injury. In previous animal studies, RIPC has provided substantial neuroprotective effects. We hypothesized that the promising neuroprotective properties were a consequence of a better oxygen consumption profile during hypothermic circulatory arrest (HCA). Design. Six 7-week-old female pigs were randomly assigned to undergo the 60 minutes of HCA with the right hind leg receiving transient RIPC preoperatively and six animals were assigned to a control group that underwent 60 minutes of HCA without any preconditioning. A combined temperature/oxygen-tension probe was inserted into the parietal cortex of each animal to monitor cerebral oxygen tension during experiments. Results. The RIPC group had significantly higher cerebral oxygen tension readings throughout the HCA. Statistically significant differences were measured from the 20 minute time point onwards in every time point up to the 60 minute time point. Conclusions. This study shows that RIPC performed before HCA conserves the cerebral oxygen tension during a circulatory arrest. RIPC could possibly prolong the safe operating time during HCA as cerebral oxygen content is preserved throughout circulatory arrest.