Effect of Remote Ischemic Preconditioning on Postoperative Complications in Visceral Surgery

A Randomized, Double- Blind Multicentric Study of the Effect of Remote Ischemic Preconditioning on Postoperative Complications in Patients Undergoing Major Minimal and Open Visceral Surgery

Remote Ischemic Preconditioning (RIPC) is mediated by intermittent brief episodes (5-10 minutes) of short ischemia in a limb (i.e. arm), followed by reperfusion. For this purpose in 3-4 cycles, a tourniquet is insufflated to suprasystolic pressure levels for 5 minutes and deflated for 5 minutes afterwards. The ischemic episodes are known to stimulate platelets and factors platelet dependent factors such as Serotonin and VEGF. These humoral factors have a systemic effect and have the potential to protect target organs (i.e. heart, kidney, liver) remote to the ischemic limb.

The purpose of this randomized controlled study is to investigate the influence and impact of RIPC on postoperative complications in patients undergoing visceral surgery

Inclusion Criteria:

• > 18 years
• Undergoing major visceral surgery

Exclusion Criteria:

• < 18 years
• Pregnancy
• Signs of Infection/Inflammation on upper limb
• Shunt
• Medical history of axillary lymph node dissection
• Signs of malperfusion of upper limb (i.e. Allen Test)
• Missing informed consent