Remote ischemic conditioning (RIC) is administered with an inflatable tourniquet by inducing brief, alternating cycles of limb ischemia and reperfusion. RIC possibly impacts the hemostatic system, and the intervention has been tested as protective therapy against ischemia-reperfusion injury and thrombotic complications in cardiac surgery and other surgical procedures. In the present systematic review, we aimed to investigate the effect of RIC on intraoperative and postoperative bleeding complications in meta-analyses of randomized controlled trials including adult patients undergoing surgery. A systematic search was performed on November 7, 2020 in PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials comparing RIC versus no RIC in adult patients undergoing surgery that reported bleeding outcomes in English publications were included. Effect estimates with 95% confidence intervals were calculated using the random-effects model for intraoperative and postoperative bleeding outcomes. Thirty-two randomized controlled trials with 3,804 patients were eligible for inclusion. RIC did not affect intraoperative bleeding volume (nine trials; 392 RIC patients, 399 controls) with the effect estimate −0.95 [−9.90; 7.99] mL (p = 0.83). RIC significantly reduced postoperative drainage volume (seven trials; 367 RIC patients, 365 controls) with mean difference −83.6 [−134.9; −32.4] mL (p = 0.001). The risk of re-operation for bleeding was reduced in the RIC group (16 trials; 838 RIC patients, 839 controls), albeit not significantly, with the relative risk 0.65 [0.39; 1.09] (p = 0.10). In conclusion, RIC reduced postoperative bleeding measured by postoperative drainage volume in this meta-analysis of adult patients undergoing surgery.

通过诱导肢体缺血和再灌注的短暂交替循环，使用充气止血带进行远程缺血调节 (RIC)。RIC 可能会影响止血系统，并且该干预已被测试作为心脏手术和其他外科手术中缺血再灌注损伤和血栓并发症的保护性疗法。在本系统评价中，我们旨在通过对包括接受手术的成年患者在内的随机对照试验的荟萃分析，研究 RIC 对术中和术后出血并发症的影响。2020 年 11 月 7 日在 PubMed、Embase 和 Cochrane 对照试验中央注册中心进行了系统检索。纳入在接受手术的成年患者中比较 RIC 与无 RIC 的随机对照试验，这些患者在英文出版物中报告了出血结果。使用随机效应模型计算术中和术后出血结果的 95% 置信区间的效应估计值。包含 3,804 名患者的 32 项随机对照试验符合纳入条件。RIC 不影响术中出血量（9 项试验；392 名 RIC 患者，399 名对照），效应估计值为 -0.95 [-9.90；7.99] 毫升 ( RIC 不影响术中出血量（9 项试验；392 名 RIC 患者，399 名对照），效应估计值为 -0.95 [-9.90；7.99] 毫升 ( RIC 不影响术中出血量（9 项试验；392 名 RIC 患者，399 名对照），效应估计值为 -0.95 [-9.90；7.99] 毫升 (p  = 0.83）。RIC 显着减少术后引流量（7 项试验；367 名 RIC 患者，365 名对照），平均差为 -83.6 [-134.9；-32.4] 毫升 ( p  = 0.001)。RIC 组因出血而再次手术的风险降低（16 项试验；838 名 RIC 患者，839 名对照），尽管不显着，相对风险为 0.65 [0.39；1.09] ( p  = 0.10)。总之，在这项针对接受手术的成年患者的荟萃分析中，RIC 减少了以术后引流量衡量的术后出血。