Effects of Remote Ischemic Preconditioning During Free Flap Reconstruction

NCT ID: NCT03474952

Last Updated: 2020-03-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-13

Study Completion Date

2019-12-09

Brief Summary

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Remote ischemic preconditioning (RIPC) has been revealed organ-protective effect in many previous clinical settings including coronary intervention or cardiovascular surgery. However its protective role during free flap reconstructive surgery in head and neck cancer patients has not yet been elucidated. The purpose of the current study is to evaluate the effect of RIPC on tissue oxygen saturation and skin temperature of the flap, as well as its organ-protective effect using Langendorff isolated heart ischemia-reperfusion model.

Detailed Description

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Patients undergoing free flap reconstructive surgery for head and neck cancer will be randomized to either remote ischemic preconditioning (RIPC) group or control group. On the day of surgery, after induction of anesthesia, RIPC, consisting of 4 cycles of 5-min ischemia (using pneumatic cuff pressure of 200 mmHg) followed by 5-min reperfusion at upper arm, or sham-RIPC (pressure \< 10 mmHg) will be induced in the RIPC or control group, respectively. Before completion of surgery, RIPC or sham-RIPC will be repeated. Tissue oxygen saturation and skin temperature of the flap will be recorded until postoperative day 1.

As a sub-study, blood samples will be obtained before and after RIPC/sham-RIPC. From them, plasma dialysate will be prepared to use for Langendorff isolated heart model. Myocardial infarct size of Langendorff rat heart will be compared between the groups to evaluate organ protective effect of RIPC during free flap reconstuctive surgery.

Conditions

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Remote Ischemic Preconditioning

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

RIPC group and control (sham-RIPC) group
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Remote ischemic preconditioning (RIPC)

Intervention is remote ischemic preconditioning (RIPC) consists of 4 cycles of 5-min ischemia (using pneumatic cuff pressure of 200 mmHg) and subsequent 5-min reperfusion applied to upper arm.

Group Type EXPERIMENTAL

remote ischemic preconditioning (RIPC)

Intervention Type PROCEDURE

remote ischemic preconditioning consists of 4 cycles of 5-min ischemia and subsequent 5-min reperfusion using pneumatic cuff applied to upper arm

Control (Sham-RIPC)

Intervention is Sham-RIPC (ischemia pressure \< 10 mmHg) applied to upper arm.

Group Type SHAM_COMPARATOR

sham-RIPC

Intervention Type PROCEDURE

ischemia pressure less than 10 mmHg (sham-RIPC)

Interventions

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remote ischemic preconditioning (RIPC)

remote ischemic preconditioning consists of 4 cycles of 5-min ischemia and subsequent 5-min reperfusion using pneumatic cuff applied to upper arm

Intervention Type PROCEDURE

sham-RIPC

ischemia pressure less than 10 mmHg (sham-RIPC)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* patients undergoing free flap reconstructive surgery

Exclusion Criteria

* BMI \< 18, \> 35 kg/m\^2
* AV fistula at arm, any reason to protect arm
* vascular abnormality or discomfort at arm
* peripheral vascular disease, peripheral neuropathy, or coagulopathy
* uncontrolled diabetes mellitus
* preoperative use of beta-blocker
* history of radiation therapy
* refuse to enrol
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Youn Joung Cho, MD

Clinical assistant professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Youn Joung Cho, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Seoul National University Hospital

Locations

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Seoul National University Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Min SH, Choe SH, Kim WS, Ahn SH, Cho YJ. Effects of ischemic conditioning on head and neck free flap oxygenation: a randomized controlled trial. Sci Rep. 2022 May 17;12(1):8130. doi: 10.1038/s41598-022-12374-3.

Reference Type DERIVED
PMID: 35581399 (View on PubMed)

Other Identifiers

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RIPC during free flap

Identifier Type: -

Identifier Source: org_study_id

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