Methods and system for performing remote ischemic preconditioning

• US 8,790,266 B2
• Filed: 03/08/2010
• Issued: 07/29/2014
• Est. Priority Date: 12/06/2006
• Status: Active Grant

• Current Assignee: Hospital For SICK Children
• Original Assignee: Hospital For SICK Children
• Inventors: Caldarone, Christopher, Redington, Andrew
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US12/719,283
• Publication Number:
  US 20100160799A1
• Time in Patent Office: 1,604 Days
• Field of Search: 600/483, 600/485, 600490-504, 606201-203
• US Class Current: 600/490
• CPC Class Codes: A61B 17/132 Tourniquets sphygmomanometer A61B5/022
• CPC Class Codes: A61B 17/135 inflatable for measuring blood pressure A61B5/022; inflatable pressure pads A61F5/34
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/02233 Occluders specially adapted therefor tourniquets A61B17/132
• CPC Class Codes: A61H 2201/165 Wearable interfaces
• CPC Class Codes: A61H 2201/5007 computer controlled
• CPC Class Codes: A61H 2201/5071 Pressure sensors
• CPC Class Codes: A61H 2201/5082 Temperature sensors
• CPC Class Codes: A61H 2230/30 Blood pressure A61H2230/04 takes precedence
• CPC Class Codes: A61H 9/0078 with intermittent or alternately inflated bladders or cuffs mattresses for preventing bed-sores with alternated pressurized chambers A61G7/05776
• CPC Class Codes: A61H 9/0092 Cuffs therefor

Abstract

A system for remote ischemic preconditioning that includes a cuff, and actuator, and a controller that operates the actuator according to a treatment protocol. The treatment protocol includes a plurality of treatment cycles that each comprise cuff actuation, an ischemic duration, cuff release, and a reperfusion duration.

Claims

1. A method of performing remote ischemic preconditioning to render tissue resistant to injury during subsequent ischemic episodes, the method comprising:

positioning a cuff about a limb of a subject at a location remote from the tissue being rendered resistant;

initiating a treatment protocol that is controlled by a controller and that includes a plurality of treatment cycles that include at least a first treatment cycle and a second treatment cycle;

the first treatment cycle comprising;

compressing the limb of the subject with pressure applied by the cuff to occlude blood flow through the limb for a first ischemic duration that lasts for at least a minute; and

releasing pressure applied to the limb by the cuff to allow blood flow through the limb for a first reperfusion duration that lasts at least one minute;

the second treatment cycle comprising;

compressing the limb of the subject with pressure applied by the cuff to occlude blood flow through the limb for a second ischemic duration that lasts for at least a minute; and

releasing pressure applied to the limb by the cuff to allow blood flow through the limb for a second reperfusion duration that lasts at least one minute; and

removing the cuff from the limb of the subject.

2. The method of claim 1, wherein the first ischemic duration is longer than the second ischemic duration.

3. The method of claim 1, wherein the second ischemic duration is longer than the first ischemic duration.

4. The method of claim 1, wherein the treatment protocol includes additional treatment cycles.

5. The method of claim 4, wherein at least one of the additional treatment cycles occurs before the first treatment cycle.

6. The method of claim 1, wherein at least one of the first ischemic duration and the second ischemic duration are at least five minutes long.

7. The method of claim 1, wherein at least one of the first ischemic duration and the second ischemic duration are at least ten minutes long.

8. The method of claim 1, wherein at least one of the first ischemic duration and the second ischemic duration are at least twenty minutes long.

9. A method of performing remote ischemic preconditioning to render tissue resistant to injury during subsequent ischemic episodes, the method comprising:

positioning a cuff about a limb of a subject at a location remote from the tissue being rendered resistant;

initiating a treatment protocol that is controlled by a controller and that includes a plurality of sequentially actuated treatment cycles, including a first treatment cycle, a second treatment cycle, and a third treatment cycle;

the first treatment cycle comprising;

compressing the limb of the subject with pressure applied by the cuff to occlude blood flow through the limb for a first ischemic duration that lasts for at least a minute; and

releasing pressure applied to the limb by the cuff in to allow blood flow through the limb for a first reperfusion duration that lasts at least one minute;

the second treatment cycle comprising;

compressing the limb of the subject with pressure applied by the cuff to occlude blood flow through the limb for a second ischemic duration that lasts for at least a minute; and

releasing pressure applied to the limb by the cuff to allow blood flow through the limb for a second reperfusion duration that lasts at least one minute;

the third treatment cycle comprising;

compressing the limb of the subject with pressure applied by the cuff to occlude blood flow through the limb for a third ischemic duration that lasts for at least a minute; and

releasing pressure applied to the limb by the cuff to allow blood flow through the limb; and

removing the cuff from the limb of the subject.

10. The method of claim 9, wherein the first reperfusion duration is longer than the second reperfusion duration.

11. The method of claim 9, wherein the second reperfusion duration is longer than the first reperfusion duration.

12. The method of claim 9, wherein the treatment protocol includes additional treatment cycles.

13. The method of claim 12, wherein at least one of the additional treatment cycles occurs before the first treatment cycle.

14. The method of claim 9, wherein at least one of the first reperfusion duration and the second reperfusion duration are at least five minutes long.

15. The method of claim 9, wherein at least one of the first reperfusion duration and the second reperfusion duration are at least ten minutes long.

16. The method of claim 9, wherein at least one of the first reperfusion duration and the second reperfusion duration are at least twenty minutes long.

17. The method of claim 9, wherein the wherein the first ischemic duration and the- second ischemic duration are of different lengths of time.

18. The method of claim 17, wherein the second ischemic duration is longer than the first ischemic duration.

19. A system for remote ischemic preconditioning, the system comprising:

a cuff configured to contract about a limb of a subject;

an actuator connected to the cuff and that, when actuated, causes the cuff to contract about the limb of the subject to reduce blood flow therethrough; and

a controller that controls the actuator to operate according to a treatment protocol that includes a plurality of sequentially actuated treatment cycles, each treatment cycle comprising;

cuff actuation, during which the actuator contracts the cuff about the limb of the subject to a pressure to occlude blood flow through the limb;

an ischemic duration, during which the cuff is contracted about the limb to occlude blood flow though the limb, the ischemic duration lasting for at least about a minute;

cuff release, during which the actuator releases the cuff to allow blood flow through the limb; and

a reperfusion duration, during which the cuff is in an at least partially relaxed state to allow blood flow through the limb, the reperfusion duration lasting for at least one minute.

20. The system of claim 19, wherein cuff actuation includes the actuator contracting about the limb of the subject to a set point pressure.

21. The system of claim 20, wherein the set point pressure is about 200 mm Hg.

22. The system of claim 21, wherein during the ischemic duration, the controller controls the actuator to maintain the pressure at about 200 mm Hg.