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Remote ischaemic preconditioning on gene expression and circulating proteins after subacute laparoscopic cholecystectomy: randomized clinical trial.
Wahlstrøm, Kirsten L; Balsevicius, Lukas; Hansen, Hannah F; Kvist, Madeline; Burcharth, Jakob; Skovsted, Gry; Lykkesfeldt, Jens; Gögenur, Ismail; Ekeloef, Sarah.
Afiliación
  • Wahlstrøm KL; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
  • Balsevicius L; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
  • Hansen HF; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
  • Kvist M; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
  • Burcharth J; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
  • Skovsted G; Section of Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Lykkesfeldt J; Section of Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Gögenur I; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark.
  • Ekeloef S; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
BJS Open ; 8(4)2024 Jul 02.
Article en En | MEDLINE | ID: mdl-39076000
ABSTRACT

BACKGROUND:

Surgical stress may lead to postsurgical hypercoagulability, endothelial dysfunction and systemic inflammation, which can impact on patient recovery. Remote ischaemic preconditioning is a procedure that activates the body's endogenous defences against ischaemia and reperfusion injury. Studies have suggested that remote ischaemic preconditioning has antithrombotic, antioxidative and anti-inflammatory effects. The hypothesis was that remote ischaemic preconditioning reduces surgery-induced systemic stress response.

METHOD:

During a 24-month period (2019-2021), adult patients undergoing subacute laparoscopic cholecystectomy due to acute cholecystitis were randomized to remote ischaemic preconditioning or control. Remote ischaemic preconditioning was performed less than 4 h before surgery on the upper arm. It consisted of four cycles of 5 min ischaemia and 5 min reperfusion. The gene expression of 750 genes involved in inflammatory processes, oxidative stress and endothelial function was investigated preoperatively and 2-4 h after surgery in both groups. In addition, changes in 20 inflammation- and vascular trauma-associated proteins were assessed preoperatively, 2-4 h after surgery and 24 h after surgery.

RESULTS:

A total of 60 patients were randomized. There were no statistically significant differences in gene expression 2-4 h after surgery between the groups (P > 0.05). Remote ischaemic preconditioning did not affect concentrations of circulating proteins up to 24 h after surgery (P > 0.05).

CONCLUSION:

The study did not demonstrate any effect of remote ischaemic preconditioning on expression levels of the chosen genes or in circulating immunological cytokines and vascular trauma-associated proteins up to 24 h after subacute laparoscopic cholecystectomy in patients with acute cholecystitis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistectomía Laparoscópica / Precondicionamiento Isquémico Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BJS Open Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistectomía Laparoscópica / Precondicionamiento Isquémico Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BJS Open Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido