Cardiothoracic & vascular anesthesia
Efficacy of remote ischaemic preconditioning on outcomes following non-cardiac non-vascular surgery: a systematic review and meta-analysis
Authors' conclusion
This meta-analysis did not show an improvement in the primary outcomes of interest with the use of RIPC. RIPC was associated with a small improvement in certain surrogate parameters of organ function and small reduction in hospital length of stay.
Study context
- Population
- Patients undergoing non-cardiac non-vascular (NCNV) surgery36 RCTs
- Comparison
- Remote ischaemic preconditioning vs no remote ischaemic preconditioning (RIPC)
- Outcome
- Cardiac and renal morbidity
Methodological detailsrandom effects model, RoB 2 risk-of-bias assessment
- Random effects model
- RoB 2 risk-of-bias assessment
Pooled result
As reported in the abstract
Cardiac and renal morbidity (postoperative troponin, AKI)
- No significant difference in postoperative troponin or AKI
Further pooled results
| Outcome | MD (mmHg) (95% CI) | P value | |
|---|---|---|---|
| Oxygenation (PaO2/FiO2)5 studies, 420 patients; I2 = 89% | 51.51 (27.32–75.69) | P < 0.01 | |
| −50050100Difference, mmHg (linear scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Postoperative serum creatinine9 studies, 914 patients; I2 = 5% | MD - 3.81 µmol/L (95% CI - 6.79 to - 0.83) | P = 0.01 |
| Renal stress biomarker (NGAL)5 studies, 379 patients; I2 = 86% | SMD - 0.66 (95% CI - 1.27 to - 0.06) | P = 0.03 |
| Oxidative stress biomarker (malondialdehyde)3 studies, 100 patients; I2 = 91% | MD - 1.24 µmol/L (95% CI - 2.4 to - 0.07) | P = 0.04 |
| Hospital LOS15 studies, 2110 patients; I2 = 88% | MD - 0.99 days (95% CI - 1.75 to - 0.23) | P = 0.01 |
Original publication
Efficacy of remote ischaemic preconditioning on outcomes following non-cardiac non-vascular surgery: a systematic review and meta-analysis. Perioper Med (Lond). Published 10 April 2023. doi:10.
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