Abstract
Ischaemic preconditioning is a phenomenon where prior minor ischaemic events allows organs to better withstand further episodes of ischaemia. Preconditioning downgrades the effects of ischaemia from necrosis to apoptosis to cell survival. It occurs in a wide variety of tissues, but it is most widely studied in the heart, and it occurs after a range of stimuli including hypoxia and the use of volatile anaesthetic agents. In this article, we look at the basic science, mechanisms, and potential uses of preconditioning.
Highlights
There is growing evidence that volatile agents may offer organs protection from ischaemia, in particular, the heart
Volatile agents appear to offer both short- and long-term protection from ischaemic insults [1], which is known as anaesthetic preconditioning
Preconditioning occurs across a wide variety of tissues; it was first noted to prevent ischaemia in the myocardium
Summary
There is growing evidence that volatile agents may offer organs protection from ischaemia, in particular, the heart. Volatile agents appear to offer both short- and long-term protection from ischaemic insults [1], which is known as anaesthetic preconditioning. This article describes the types of preconditioning and the mechanisms by which they are thought to occur. It describes the clinical application of preconditioning, focussing on its role in cardiac protection. Preconditioning occurs across a wide variety of tissues; it was first noted to prevent ischaemia in the myocardium. The heart is one of the few organs where it is possible to measure function or damage (troponins, echocardiograms, etc.), meaning it has been the most widely investigated. Later preconditioning has been observed in the brain, and it has been suggested to offer protection to the liver, kidneys, muscle and gut
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