Research by Victoria PhD student Jennifer Williams could lead to better recovery outcomes for surgery patients.
The Clinical Research student is investigating the potential for a simple pre-surgery technique that could reduce organ damage following surgery.
"One of the major problems associated with recovering from surgery is the tissue damage to organs caused when blood flow, and therefore oxygen, is temporarily restricted.
"For example, during a cardiac bypass or valve operation, the circulation of blood through a patient's heart is suspended and rerouted through a machine. When blood flow is restored it can damage the heart muscle, leading to inflammation. This inflammation is often widespread, causing damage to the kidneys and lungs, and can even be fatal."
Jennifer's research aims to help solve this problem by revealing new information about a simple technique known as Remote Ischaemic Preconditioning (RIPC).
This technique was discovered in 1986, when researchers observed that the body could be 'prepared' for a lack of oxygen by temporarily restricting blood flow to a limb—usually an arm—immediately before surgery. The subsequent tissue damage was shown to be significantly reduced.
Jennifer's primary supervisor is Dr Anne La Flamme, an associate professor in Cell and Immunobiology research in Victoria's School of Biological Sciences.
Anne, who also leads multiple sclerosis research at the Malaghan Institute of Medical Research, says the theory behind RIPC is that the brief restriction of oxygen 'activates' the body, preparing it for more substantial trauma.
Clinical trials into the effectiveness of RIPC began in 2000, but have so far produced mixed results.
"One of the main reasons for this ambiguity is that we still don't fully understand all the pathways involved," Jennifer says.
Jennifer became interested in RIPC during her Honours year, when she assisted Dr Paul Young at Wellington Hospital to conduct a trial with highrisk cardiac surgery patients.
To shed new light on the technique, Jennifer is now designing and conducting clinical trials using healthy volunteers.
"The idea behind using healthy volunteers is that surgery patients, especially cardiac patients, often take medication or have additional health conditions that interfere with accurate testing.
"It's quite straightforward: we inflate a bloodpressure cuff on the upper arm of a patient for five minutes, release it for five minutes and repeat two more times."
Jennifer then analyses cells from the volunteer's blood samples taken before and after RIPC.
The subsequent changes in blood cells are leading her to believe that the body's immune response is key to understanding RIPC.
Jennifer says two areas of research interest are the white blood cells called neutrophils, thought to be largely responsible for damaging organ tissue following surgery; and cytokines, the 'hormones of the immune system', which play a fundamentalrole in cell interaction.
"One consistent effect we've observed is that preconditioning seems to reduce the activation of neutrophils, and Jennifer's study is the first to show this reduction occurring very quickly after preconditioning—within the first four hours," says Anne.
Jennifer is planning a further trial using healthy volunteers to discover whether a stronger response from the immune system occurs when RIPC is applied 24 hours before testing the blood.
"This may give the body even more time to respond, and be even better prepared for surgery."
Jennifer says it's exciting working in an area of medical research where so little is known, and she believes the technique could eventually be applied more widely.
"If we can improve outcomes for surgery patients with such a simple technique, then that would be incredible."
Explore further: Simple blood pressure cuff inflation reduces heart injury from bypass surgery
Medical Xpress on facebook
Related Stories
Simple blood pressure cuff inflation reduces heart injury from bypass surgery
Aug 15, 2013
The study, led by Professor Gerd Heusch of the Institute for Pathophysiology, and Dr Matthias Thielmann, of the Department of Thoracic and Cardiovascular Surgery, both based at the University School of Medicine Essen, Germany, ...
Blood pressure cuff may save lives in patients with acute heart attack
Sep 20, 2013
In patients with an acute heart attack, remote ischemic conditioning – intermittent inflation of a blood pressure cuff to cut off blood flow to the arm during transportation to hospital for acute balloon ...
Scientists first to see trafficking of immune cells in beating heart
Jul 11, 2012
Blood flow to the heart often is interrupted during a heart attack or cardiac surgery. But when blood flow resumes, the heart may still falter. That's because collateral damage can occur as blood re-enters ...
Cardiac study used as source for new guidelines on treating people undergoing coronary artery bypass surgery
May 24, 2013
Cardiac research from the University of Alberta had serious impact as a source for the American College of Cardiology and the American Heart Association's new guidelines on how to treat patients undergoing coronary artery ...
Rogue blood cells may contribute to post-surgery organ damage
Jun 26, 2011
A study from scientists at Queen Mary, University of London, sheds new light on why people who experience serious trauma or go through major surgery, can suffer organ damage in parts of the body which are seemingly unconnected ...
Recommended for you
Study confirms benefit of back braces in treating scoliosis
Nov 13, 2013
(Medical Xpress)—For years, adolescents instructed to wear back braces to correct scoliosis have protested having to wear the rigid plastic devices. Considering the lack of evidence in support of bracing, ...
Bariatric surgery can lead to premature birth
Nov 12, 2013
Babies born of women who have undergone bariatric (weight-loss) surgery are more likely to be premature and to be small for gestational age, according to a large registry study carried out at Karolinska Institutet in Sweden ...
Orthopaedic surgeon says anterolateral ligament not "new" but promising for ACL injuries
Nov 11, 2013
While anterior cruciate ligament (ACL) reconstruction surgery is a widely accepted and proven procedure, according to a renowned orthopaedic surgeon at Western University, there is still an unacceptably high re-injury rate ...
New targeted therapy to treat facial lesions
Nov 08, 2013
Research conducted by Roy G. Geronemus, M.D. and Yoon-Soo Cindy Bae-Harboe, M.D., was selected as Editor's Choice for the November 2013 issue of Lasers in Surgery and Medicine (LSM).
Obesity may limit overall function two years after shoulder replacement surgery
Nov 07, 2013
Patients with obesity undergo a disproportionately higher number of elective orthopaedic surgeries in the U.S. Obesity has been linked to higher costs, complications, infections and revisions in total knee and total hip replacement ...
Study examines effect of sleep deficiency and possible surgical complications
Nov 05, 2013
Surgeons who had operated the night before an elective daytime gallbladder surgery did not have a higher rate of complications, according to a study in the November 6 issue of JAMA.
User comments
© Medical Xpress 2011-2013, Phys.org network
Research by Victoria PhD student Jennifer Williams could lead to better recovery outcomes for surgery patients.
The Clinical Research student is investigating the potential for a simple pre-surgery technique that could reduce organ damage following surgery.
"One of the major problems associated with recovering from surgery is the tissue damage to organs caused when blood flow, and therefore oxygen, is temporarily restricted.
"For example, during a cardiac bypass or valve operation, the circulation of blood through a patient's heart is suspended and rerouted through a machine. When blood flow is restored it can damage the heart muscle, leading to inflammation. This inflammation is often widespread, causing damage to the kidneys and lungs, and can even be fatal."
Jennifer's research aims to help solve this problem by revealing new information about a simple technique known as Remote Ischaemic Preconditioning (RIPC).
This technique was discovered in 1986, when researchers observed that the body could be 'prepared' for a lack of oxygen by temporarily restricting blood flow to a limb—usually an arm—immediately before surgery. The subsequent tissue damage was shown to be significantly reduced.
Jennifer's primary supervisor is Dr Anne La Flamme, an associate professor in Cell and Immunobiology research in Victoria's School of Biological Sciences.
Anne, who also leads multiple sclerosis research at the Malaghan Institute of Medical Research, says the theory behind RIPC is that the brief restriction of oxygen 'activates' the body, preparing it for more substantial trauma.
Clinical trials into the effectiveness of RIPC began in 2000, but have so far produced mixed results.
"One of the main reasons for this ambiguity is that we still don't fully understand all the pathways involved," Jennifer says.
Jennifer became interested in RIPC during her Honours year, when she assisted Dr Paul Young at Wellington Hospital to conduct a trial with highrisk cardiac surgery patients.
To shed new light on the technique, Jennifer is now designing and conducting clinical trials using healthy volunteers.
"The idea behind using healthy volunteers is that surgery patients, especially cardiac patients, often take medication or have additional health conditions that interfere with accurate testing.
"It's quite straightforward: we inflate a bloodpressure cuff on the upper arm of a patient for five minutes, release it for five minutes and repeat two more times."
Jennifer then analyses cells from the volunteer's blood samples taken before and after RIPC.
The subsequent changes in blood cells are leading her to believe that the body's immune response is key to understanding RIPC.
Jennifer says two areas of research interest are the white blood cells called neutrophils, thought to be largely responsible for damaging organ tissue following surgery; and cytokines, the 'hormones of the immune system', which play a fundamentalrole in cell interaction.
"One consistent effect we've observed is that preconditioning seems to reduce the activation of neutrophils, and Jennifer's study is the first to show this reduction occurring very quickly after preconditioning—within the first four hours," says Anne.
Jennifer is planning a further trial using healthy volunteers to discover whether a stronger response from the immune system occurs when RIPC is applied 24 hours before testing the blood.
"This may give the body even more time to respond, and be even better prepared for surgery."
Jennifer says it's exciting working in an area of medical research where so little is known, and she believes the technique could eventually be applied more widely.
"If we can improve outcomes for surgery patients with such a simple technique, then that would be incredible."
Explore further: Simple blood pressure cuff inflation reduces heart injury from bypass surgery
Medical Xpress on facebook
Related Stories
Simple blood pressure cuff inflation reduces heart injury from bypass surgery
Aug 15, 2013
The study, led by Professor Gerd Heusch of the Institute for Pathophysiology, and Dr Matthias Thielmann, of the Department of Thoracic and Cardiovascular Surgery, both based at the University School of Medicine Essen, Germany, ...
Blood pressure cuff may save lives in patients with acute heart attack
Sep 20, 2013
In patients with an acute heart attack, remote ischemic conditioning – intermittent inflation of a blood pressure cuff to cut off blood flow to the arm during transportation to hospital for acute balloon ...
Scientists first to see trafficking of immune cells in beating heart
Jul 11, 2012
Blood flow to the heart often is interrupted during a heart attack or cardiac surgery. But when blood flow resumes, the heart may still falter. That's because collateral damage can occur as blood re-enters ...
Cardiac study used as source for new guidelines on treating people undergoing coronary artery bypass surgery
May 24, 2013
Cardiac research from the University of Alberta had serious impact as a source for the American College of Cardiology and the American Heart Association's new guidelines on how to treat patients undergoing coronary artery ...
Rogue blood cells may contribute to post-surgery organ damage
Jun 26, 2011
A study from scientists at Queen Mary, University of London, sheds new light on why people who experience serious trauma or go through major surgery, can suffer organ damage in parts of the body which are seemingly unconnected ...
Recommended for you
Study confirms benefit of back braces in treating scoliosis
Nov 13, 2013
(Medical Xpress)—For years, adolescents instructed to wear back braces to correct scoliosis have protested having to wear the rigid plastic devices. Considering the lack of evidence in support of bracing, ...
Bariatric surgery can lead to premature birth
Nov 12, 2013
Babies born of women who have undergone bariatric (weight-loss) surgery are more likely to be premature and to be small for gestational age, according to a large registry study carried out at Karolinska Institutet in Sweden ...
Orthopaedic surgeon says anterolateral ligament not "new" but promising for ACL injuries
Nov 11, 2013
While anterior cruciate ligament (ACL) reconstruction surgery is a widely accepted and proven procedure, according to a renowned orthopaedic surgeon at Western University, there is still an unacceptably high re-injury rate ...
New targeted therapy to treat facial lesions
Nov 08, 2013
Research conducted by Roy G. Geronemus, M.D. and Yoon-Soo Cindy Bae-Harboe, M.D., was selected as Editor's Choice for the November 2013 issue of Lasers in Surgery and Medicine (LSM).
Obesity may limit overall function two years after shoulder replacement surgery
Nov 07, 2013
Patients with obesity undergo a disproportionately higher number of elective orthopaedic surgeries in the U.S. Obesity has been linked to higher costs, complications, infections and revisions in total knee and total hip replacement ...
Study examines effect of sleep deficiency and possible surgical complications
Nov 05, 2013
Surgeons who had operated the night before an elective daytime gallbladder surgery did not have a higher rate of complications, according to a study in the November 6 issue of JAMA.
User comments
© Medical Xpress 2011-2013, Phys.org network
0 comments:
Post a Comment