The Effect of Remote Ischemic Preconditioning on the Ischemic Reperfusion Injury in Infants With Ventricular Septal Defect and Pulmonary Hypertension
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Purpose
Intraoperative myocardial and pulmonary protection is important for better outcome after cardiac surgery. Ischemic preconditioning is one of organ protective strategies against ischemia-reperfusion injury by applying brief ischemia to the target organ before a subsequent critical ischemia, and its effect has been confirmed. However, its clinical application is not easy because ischemic insult may aggravate the function of vulnerable organ.
On the other hand, remote ischemic preconditioning (RIPC) is another protective approach by applying ischemia to other less vulnerable organ such as skeletal muscle before critical ischemia-reperfusion injury to heart. The effect of RIPC has been well demonstrated in adults and children. However, Little is known about the effect of remote ischemic precondition on the pediatric myocardium to ischemia and reperfusion injury. The effect of RIPC on the children remains to be further evaluated because the degree of ischemia-reperfusion injury is different according to age, cardiac pathology and cyanosis. In addition, the previous report on children dealt with a diverse range of congenital heart defects with a wide age range. The purpose of this study was to evaluate the effect of RIPC on myocardial and pulmonary protection in infants with pulmonary hypertension who need repair of simple ventricular septal defect.
| Condition | Intervention |
|---|---|
|
Ventricular Septal Defect Pulmonary Hypertension |
Other: remote ischemic preconditioning (RIPC) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Prevention |
- troponin level [ Time Frame: within the 1 day after operation ] [ Designated as safety issue: Yes ]troponin level will be checked 1, 6, 12 and 24 hours after operation. After making a graph for troponin-time, area under curve will be calculated.
| Enrollment: | 60 |
| Study Start Date: | December 2010 |
| Study Completion Date: | April 2011 |
| Primary Completion Date: | April 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: remote ischemic preconditioning |
Other: remote ischemic preconditioning (RIPC)
RIPC will be performed by 5-min cycles of lower limb ischemia reperfusion using blood pressure cuff
|
Eligibility| Ages Eligible for Study: | up to 1 Year |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- perimembranous or muscular outlet or muscular inlet ventricular septal defect
- pulmonary hypertension (+)
- infant (<1 year)
Exclusion Criteria:
- subarterial ventricular defect
- chromosomal defect
- airway or parenchymal lung disease
- blood disorder
- anticipation of cardiac muscle resection
Contacts and Locations
More Information
No publications provided by Seoul National University Hospital
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Jin-Tae Kim, assistant professor, Seoul National University Hospital |
| ClinicalTrials.gov Identifier: | NCT01313832 History of Changes |
| Other Study ID Numbers: | H-1012-120-345 |
| Study First Received: | March 10, 2011 |
| Last Updated: | February 1, 2012 |
| Health Authority: | Korea: Food and Drug Administration |
Keywords provided by Seoul National University Hospital:
|
ventricular septal defect remote ischemic preconditioning pulmonary hypertension infant with ventricular septal defect and pulmonary hypertension |
Additional relevant MeSH terms:
|
Heart Septal Defects Heart Septal Defects, Ventricular Hypertension Hypertension, Pulmonary Reperfusion Injury Heart Defects, Congenital Cardiovascular Abnormalities Cardiovascular Diseases |
Heart Diseases Congenital Abnormalities Vascular Diseases Lung Diseases Respiratory Tract Diseases Postoperative Complications Pathologic Processes |
ClinicalTrials.gov processed this record on May 22, 2013