Thursday, February 27, 2014

Ischemic preconditioning to reduce contrast induced nephropathy

It proved effective in this study of patients at renal risk undergoing coronary angiography:

Contrast medium–induced acute kidney injury occurred in 26 patients (26%), 20 (40%) in the control group and 6 (12%) in the remote ischemic preconditioning group (odds ratio, 0.21; 95% confidence interval, 0.07–0.57; P=0.002). No major adverse events were related to remote ischemic preconditioning.

Despite the fact that this was published a year and a half ago it hasn't made prime time as far as I can tell. Imagine doing this to a patient:

IPC was accomplished by performing 4 cycles of alternating 5-minute inflation and 5-minute deflation of a standard upper-arm blood pressure cuff to the individual's systolic blood pressure plus 50 mm Hg to induce transient and repetitive arm ischemia and reperfusion. IPC was started immediately before CA.

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