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Effect of remote ischemic preconditioning on hemostasis and fibrinolysis in head and neck cancer surgery: A randomized controlled trial. | LitMetric

AI Article Synopsis

  • The study aimed to determine if remote ischemic preconditioning (RIPC) could lower platelet aggregation and enhance fibrinolysis, potentially reducing thrombosis risk in cancer patients during surgery.
  • Head and neck cancer patients were randomized to either the RIPC intervention or a sham procedure, with platelet aggregation and fibrinolysis measurements taken post-surgery.
  • The results showed no significant difference in platelet aggregation, fibrinolysis, or incidence of thromboembolic complications between the RIPC and sham groups, indicating that RIPC did not have an impact in this context.

Article Abstract

Introduction: The aim of this randomized controlled trial was to investigate if remote ischemic preconditioning (RIPC) reduced platelet aggregation and increased fibrinolysis in cancer patients undergoing surgery and thereby reduced the risk of thrombosis.

Materials And Methods: Head and neck cancer patients undergoing tumor resection and microsurgical reconstruction were randomized 1:1 to RIPC or sham intervention. RIPC was administered intraoperatively with an inflatable tourniquet by four cycles of 5-min upper extremity occlusion and 5-min reperfusion. The primary endpoint was collagen-induced platelet aggregation measured with Multiplate as area-under-the-curve on the first postoperative day. Secondary endpoints were markers of primary hemostasis, secondary hemostasis, and fibrinolysis. Clinical data on thromboembolic and bleeding complications were prospectively collected at 30-day follow-up. An intention-to-treat analysis was performed.

Results: Sixty patients were randomized to RIPC (n = 30) or sham intervention (n = 30). No patients were lost to follow-up. The relative mean [95% confidence interval] collagen-induced platelet aggregation was 1.26 [1.11;1.40] in the RIPC group and 1.17 [1.07;1.27] in the sham group on the first postoperative day reported as ratios compared with baseline (P = 0.30). Median (interquartile range) 50% fibrin clot lysis time was 517 (417-660) sec in the RIPC group and 614 (468-779) sec in the sham group (P = 0.25). The postoperative pulmonary embolism rate did not differ between groups (P = 1.0).

Conclusions: RIPC did not influence hemostasis and fibrinolysis in head and neck cancer patients undergoing surgery. RIPC did not reduce the rate of thromboembolic complications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613699PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219496PLOS

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