SynthesisNeurocritical care2026
Remote Ischemic Conditioning After Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis.
Synthesis in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRemote ischemic conditioning (RIC), an intervention in which brief episodes of ischemia are applied to an organ or tissue to induce remote organs' tolerance of subsequent ischemic injury, has shown potential in reducing the incidence of delayed cerebral ischemia (DCI) secondary an aneurysmal subarachnoid hemorrhage (aSAH). This review aimed to evaluate the effectiveness of RIC in patients with SAH.
methodsA comprehensive search was conducted to identify peer-reviewed randomized controlled trials (RCT) and non-randomized studies comparing RIC with no conditioning or sham procedures in adults with SAH. Outcomes of interest were mortality, DCI, and neurological status. Risk of bias was assessed using the Cochrane RoB 2.0 tool for RCTs and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomized studies. We conducted random-effects meta-analysis to obtain pooled risk ratios (RR) and assessed certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
resultsFour clinical trials and one cohort study with a total of 200 patients fulfilled selection criteria and were included for synthesis. We did not find a statistically significant effect of RIC on mortality (RR = 0.69, 95% CI 0.21-2.27), cerebral infarction (RR = 1.04, 95% CI 0.44-2.45)m or unfavorable neurological outcomes (RR = 0.73, 95% CI 0.51-1.05). Significant variability in outcome definitions and reporting precluded pooled analysis for vasospasm.
conclusionsCurrently, evidence does not support the efficacy of RIC in the management of SAH. The lack of standardized protocols and clinical definitions limits the ability to confirm a therapeutic effect. More rigorous and uniform trials are necessary to definitively establish its potential benefits.
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