Remote Ischemic Conditioning

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Rialaigh

Forum Asst. Chief
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I put this in ALS because the potential greatest use prehospital would be for STEMI patients, however this is as simple as putting a manual BP cuff on.

http://www.jems.com/article/patient-care/remote-ischemic-conditioning-during-myoc

Thoughts?

Seems very promising pending more study in actually making a difference in short term and long term outcomes on patients experiencing MI's or injury or infarcts of any kind to any organ really.



Also has anyone heard more about the continuing study or seen any trials in their area>?
 
MonkeyArrow

MonkeyArrow

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I have heard about ischemic pre- and post-conditioning but I believed that they only applied to cardiac arrest. When a patient has had a downtime greater than 5 minutes, you try to basically send waves of blood to the brain and heart. This is known as stutter CPR and is a form of ischemic post-conditioning. Ischemic pre-conditioning is done exclusively in-hospital from what I have heard, pre-infarct, to strengthen and build resilience to re-perfusion injury in a high risk patient by occluding off the coronary and carotid arteries for short periods of time.
 
A

Aprz

The New Beach Medic
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This is the first time I am reading/hearing about this. Interesting. Thank you for sharing.
 
CANMAN

CANMAN

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My program did a study on it, was in trial phase last year, and was moved into the actual protocol this year for STEMI's. Exclusion criteria would be a patient who has received thrombolytics for the STEMI, history of thrombosis in either arm, mastectomy, or systolics less then 100/ on a vasopressor. We do a total of 4 cycles, 5 minutes in duration, and medicate for pain/discomfort if needed.
 
S

systemet

Forum Asst. Chief
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Av8or007 said:
https://www.dropbox.com/s/frlgsrm6gnj5rhw/RIPC Trial.pdf?dl=0

Trial demonstrating significant reduction in mortality in STEMI pts.
Click to expand...

Nice study.

That being said, cardiac mortality was non-significant (p=0.26). There's also no significant difference in the rate of MI, or development of HF. The difference in MACCE is primarily driven by non-cardiac mortality (19/32). This is why I don't like composite endpoints.

But, I stand corrected. This is also currently being trialed locally in the prehospital environment.

I'm interested to see where this goes, as it's a low-technology approach that could have widespread adoption.
 
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