Use of remote ischemic conditioning for traumatic injury

• US 9,393,025 B2
• Filed: 04/08/2011
• Issued: 07/19/2016
• Est. Priority Date: 04/08/2010
• Status: Active Grant

• Current Assignee: Hospital For SICK Children
• Original Assignee: Hospital For SICK Children
• Inventors: Caldarone, Christopher
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US13/082,647
• Publication Number:
  US 20110251635A1
• Time in Patent Office: 1,929 Days
• Field of Search: 606201-203, 606/157, 606/158, 600490-492, 600/309, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61B 17/132 Tourniquets sphygmomanometer A61B5/022
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• 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

Abstract

The invention provides methods for reducing traumatic injury through the use of ischemic conditioning.

Claims

1. A method for treating a subject experiencing, or likely to experience, hypovolemia caused by a traumatic injury to protect an organ of the subject from effects associated with hypovolemia, comprising:

performing non-invasive, individual or repeated remote ischemic conditioning (RIC) regimens on a subject experiencing or likely to experience hypovolemia caused by a traumatic injury, before performance of resuscitation therapy, wherein the RIC regimens are performed on a limb of the subject remote from the organ, wherein each RIC regimen comprises two or more cycles of blood flow occlusion followed by reperfusion, wherein each cycle of blood flow occlusion has duration of one minute or more and wherein each subsequent cycle begins upon conclusion of reperfusion of a previous cycle.

2. The method of claim 1, wherein repeated RIC regimens comprise more than one RIC regimen performed on a single day.

3. The method of claim 2, wherein repeated RIC regimens comprise two, three, four or five RIC regimens performed on a single day.

4. The method of claim 1, wherein repeated RIC regimens comprise one or more RIC regimens on more than one day.

5. The method of claim 1, wherein at least one RIC regimen is performed within 30 minutes or 1 hour of the traumatic injury.

6. The method of claim 1, wherein the RIC regimens are performed before the traumatic injury.

7. The method of claim 1, wherein the RIC regimens are performed before and after the traumatic injury.

8. The method of claim 1, wherein the RIC regimens are performed before, during and after the traumatic injury.

9. The method of claim 1, wherein the RIC regimens are performed during and after the traumatic injury.

10. The method of claim 1, wherein the RIC regimens are performed after the traumatic injury.

11. The method of claim 1, wherein the subject is human.

12. The method of claim 1, wherein at least one RIC regimen comprises at least four cycles, each cycle comprising occlusion and reperfusion.

13. The method of claim 1, wherein at least one RIC regimen comprises two or more cycles of 5 minutes of occlusion and 5 minutes of reperfusion.

14. The method of claim 1, wherein at least one RIC regimen comprises at least four cycles, each cycle comprising supra-systolic pressure and reperfusion.

15. The method of claim 14, wherein the supra-systolic pressure is a pressure that is at least 15 mmHg above systolic pressure.

16. The method of claim 14, wherein the supra-systolic pressure is a pressure that is about 200 mmHg.

17. The method of claim 1, wherein at least one RIC regimen comprises two or more cycles of 5 minutes of supra-systolic pressure and 5 minutes of reperfusion.

18. The method of claim 1, wherein repeated RIC regimens are performed at the same site.

19. The method of claim 1, wherein repeated RIC regimens are performed on an upper limb.

20. The method of claim 1, wherein repeated RIC regimens are performed on a lower limb.

21. The method of claim 1, wherein the subject is hypotensive.

22. A method for treating a subject for systemic effects associated with hypovolemia caused by a traumatic injury to protect one or more organs of the subject, comprising:

performing two or more cycles of non-invasive remote blood flow occlusion followed by reperfusion on a subject experiencing or likely to experience hypovolemia caused by a traumatic injury, before onset of ischemia and performance of resuscitation therapy, wherein the two or more cycles of non-invasive remote blood flow occlusion followed by reperfusion are performed on a limb of the subject remote from the one or more organs, wherein each cycle of blood flow occlusion has a duration of one minute or more and wherein each subsequent cycle begins upon conclusion of reperfusion of a previous cycle.

23. The method of claim 22, wherein the remote blood flow occlusion and reperfusion is performed on one or more lower and/or upper limbs.

24. A method for treating a subject who is experiencing or likely to experience hypovolemia and ischemia as a result of a traumatic injury to reduce or prevent systemic effects associated with hypovolemia to protect one or more organs, comprising performing individual or repeated remote ischemic conditioning (RIC) regimens on the subject before onset of ischemia and performance of resuscitation therapy, wherein the RIC regimens are performed on a limb of the subject remote from the one or more organs, wherein each RIC regimen comprises two or more cycles of blood flow occlusion followed by reperfusion, wherein each cycle of blood flow occlusion has a duration of one minute or more and wherein each subsequent cycle begins upon conclusion of reperfusion of a previous cycle.