BACKGROUND Remote ischemic preconditioning (RIP) may protect target organs from ischemia - reperfusion injury, however, little is known on pulmonary effects of RIP prior to, immediately after and several hours after one-lung ventilation (OLV). The present randomized, controlled, animal experiment was undertaken to analyze these issues. METHODS After animal ethics committee approval, twelve piglets (26 ± 2 kg) were anesthetized and randomly assigned to a control (n = 6) or to a RIP group (n = 6). For RIP, arterial perfusion of a hind limb was suspended by an inflated blood pressure cuff (200 mmHg for 5 min) and deflated for another 5 min, this was repeated four times. After intubation, mechanical ventilation (MV) was kept constant with tidal volume 10 ml/kg, inspired oxygen fraction (FIO2) 0.40, and positive end-expiratory pressure (PEEP) 5cmH2O. FIO2 was increased to 1 after RIP in the RIP group and after the sham procedure in the control group, respectively, for the time of OLV. OLV was established by left-sided bronchial blockade. After OLV, TLV was re-established until the end of the protocol. Exhaled nitric oxide (NO) was measured by ozon chemiluminiscense and ventilatory and hemodynamic variables were assessed according to the protocol. RESULTS Hemodynamic and respiratory data were similar in both groups. Arterial pO2 was higher in the RIP group after two hours of OLV. In the control group, exhaled NO decreased during OLV and remained at low levels for the rest of the protocol. In the RIP group, exhaled NO decreased as well during OLV but returned to baseline levels when TLV was re-established. CONCLUSIONS RIP has no effects on hemodynamic and respiratory variables in juvenile, healthy piglets. RIP improves the oxygenation after OLV and prevents the decline of exhaled NO after OLV.

中文翻译：

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远程缺血预处理对单肺通气期间和之后仔猪呼出气一氧化氮浓度的影响。

背景远程缺血预处理(RIP) 可以保护靶器官免受缺血-再灌注损伤，然而，在单肺通气(OLV) 之前、之后立即和几个小时之后，对RIP 的肺部影响知之甚少。本随机、受控的动物实验旨在分析这些问题。方法 在动物伦理委员会批准后，对 12 头小猪 (26 ± 2 kg) 进行麻醉并随机分配到对照组 (n = 6) 或 RIP 组 (n = 6)。对于 RIP，后肢的动脉灌注通过充气的血压袖带（200 mmHg 持续 5 分钟）暂停并再放气 5 分钟，重复四次。插管后，机械通气 (MV) 保持恒定，潮气量为 10 ml/kg，吸入氧分数 (FIO2) 为 0.40，呼气末正压 (PEEP) 为 5cmH2O。在 OLV 时间，RIP 组 RIP 后和对照组假手术后 FIO2 分别增加至 1。OLV 是通过左侧支气管阻滞建立的。在 OLV 之后，重新建立 TLV，直到协议结束。呼出的一氧化氮 (NO) 是通过臭氧化学发光测量的, 通气和血液动力学变量根据协议进行评估。结果 两组的血流动力学和呼吸数据相似。在 OLV 两小时后，RIP 组的动脉 pO2 更高。在对照组中，在 OLV 期间呼出的 NO 减少，并在协议的其余部分保持在低水平。在 RIP 组中，OLV 期间呼出的 NO 也减少，但在 TLV 重新建立时恢复到基线水平。结论 RIP 对青少年的血流动力学和呼吸变量没有影响，健康的小猪。RIP 改善 OLV 后的氧合，防止 OLV 后呼出的 NO 下降。