2019/04/24 by Andrew Fu Wah Ho, Jun Hua Chong, Marcus Eng Hock Ong +1 · 1 citation
Medicine · Neuroscience · #Cardiac Ischemia and Reperfusion #Cardiac Arrest and Resuscitation #Anesthesia and Neurotoxicity Research #Medicine #Myocardial infarction #Subarachnoid hemorrhage #Emergency department #Stroke (engine) #Intensive care medicine #Ischemia #Reperfusion injury #Internal medicine #Cardiology
paper · doi:10.1097/shk.0000000000001362
openalex publication_date 2019/04/24 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
Time-critical acute ischemic conditions such as ST-elevation myocardial infarction and acute ischemic stroke are staples in Emergency Medicine practice. While timely reperfusion therapy is a priority, the resultant acute ischemia/reperfusion injury contributes to significant mortality and morbidity. Among therapeutics targeting ischemia/reperfusion injury (IRI), remote ischemic conditioning (RIC) has emerged as the most promising.RIC, which consists of repetitive inflation and deflation of a pneumatic cuff on a limb, was first demonstrated to have protective effect on IRI through various neural and humoral mechanisms. Its attractiveness stems from its simplicity, low-cost, safety, and efficacy, while at the same time it does not impede reperfusion treatment. There is now good evidence for RIC as an effective adjunct to reperfusion in ST-elevation myocardial infarction patients for improving clinical outcomes. For other applications such as acute ischemic stroke, subarachnoid hemorrhage, traumatic brain injury, cardiac arrest, and spinal injury, there is varying level of evidence.This review aims to describe the RIC phenomenon, briefly recount its historical development, and appraise the experimental and clinical evidence for RIC in selected emergency conditions. Finally, it describes the practical issues with RIC clinical application and research in Emergency Medicine.