{"id":1412,"date":"2015-01-05T08:00:51","date_gmt":"2015-01-05T12:00:51","guid":{"rendered":"https:\/\/edecmo.org\/?p=1412"},"modified":"2021-11-03T00:30:53","modified_gmt":"2021-11-03T04:30:53","slug":"edecmo-xx-limiting-post-arrest-ischemia-reperfusion-injury-graham-nichol","status":"publish","type":"post","link":"https:\/\/edecmo.org\/edecmo-xx-limiting-post-arrest-ischemia-reperfusion-injury-graham-nichol\/","title":{"rendered":"EDECMO 18 &#8211; Remote Ischemic Conditioning &#8211; with Graham Nichol"},"content":{"rendered":"<!--powerpress_player--><div class=\"powerpress_player\" id=\"powerpress_player_204\"><!--[if lt IE 9]><script>document.createElement('audio');<\/script><![endif]-->\n<audio class=\"wp-audio-shortcode\" id=\"audio-1412-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150105-RIC-Graham-Nichol.mp3?_=1\" \/><a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150105-RIC-Graham-Nichol.mp3\">http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150105-RIC-Graham-Nichol.mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150105-RIC-Graham-Nichol.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/edecmo.org\/?powerpress_pinw=1412-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150105-RIC-Graham-Nichol.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"edecmo-20150105-RIC-Graham-Nichol.mp3\">Download<\/a> (Duration: 20:49 &#8212; 19.2MB)<\/p><p class=\"powerpress_links powerpress_subscribe_links\">Subscribe: <a href=\"https:\/\/edecmo.org\/feed\/podcast\/\" class=\"powerpress_link_subscribe powerpress_link_subscribe_rss\" target=\"_blank\" title=\"Subscribe via RSS\" rel=\"nofollow\">RSS<\/a><\/p><h3>Remote Ischemic Conditioning to Reduce Ischemia-Reperfusion Injury after Cardiac Arrest<\/h3>\n<p>In this episode Zack and Joe talk with a true pioneer in resuscitation and the science of cardiac arrest management. Graham Nichol, from the University of Washington, \u00a0joined us at Sharp Memorial Hospital for an amazing discussion about &#8220;Remote Ischemic Conditioning&#8221; and its role in prevention of ischemia-reperfusion injury resulting from cardiac arrest. \u00a0Is this VooDoo or a real phenomenon? Listen to this episode to find out&#8230;<\/p>\n<h4 style=\"padding-left: 30px;\">Some Definitions:<\/h4>\n<ul>\n<li><em>&#8220;Ischemia-Reperfusion&#8221; injury:<\/em> \u00a0prolonged ischemia to the brain and heart often occur after circulatory arrest. Immediate CPR minimizes this phenomenon but many of our\u00a0patients who arrest in the pre-hospital setting don&#8217;t receive immediate bystander CPR, resulting in prolonged ischemia. CPR reintroduces blood flow and oxygen to the previously ischemic tissues. \u00a0This hyperoxic &#8216;reperfusion&#8217; is known to be a main contributor to infarct size in \u00a0both the heart and brain causing poor neurologic outcomes after arrest. Minimizing this reperfusion injury is major focus of resuscitative science right now.<\/li>\n<li><em>&#8220;Ischemic Conditioning&#8221;<\/em>: purposeful application of ischemia and reperfusion, off and on, to the tissues.\n<ul>\n<li>&#8220;Pre-conditioning&#8221; = applying this therapy BEFORE circulatory arrest<\/li>\n<li>&#8220;Peri-conditioning&#8221; = applying this therapy either DURING\u00a0circulatory arrest<\/li>\n<li>&#8220;Post-conditioning&#8221; = applying this therapy AFTER circulatory arrest<\/li>\n<\/ul>\n<\/li>\n<li><em><span style=\"text-decoration: underline;\">&#8220;Targeted&#8221; vs. &#8220;Remote&#8221; Ischemic Conditioning:<\/span><br \/>\n<\/em><em>\u00a0 \u00a0&#8220;Targeted&#8221; ischemic conditioning:<\/em>\u00a0application of conditioning directly to the \u00a0specific target organ (ie the heart or the brain). This can be done in one of two ways:<\/p>\n<ul>\n<li><em>systemic<\/em>\u00a0 ischemic conditioning.\n<ul>\n<li>In a pig model of cardiac arrest, Demetris Yannapoulos and Keith Lurie applied brief periods of ischemic post-conditioning\u00a0via &#8220;Stutter CPR&#8221; (3-4 cycles of 20 seconds of CPR with 20 second pauses) after prolonged &#8220;no flow&#8221; arrest &#8211; upwards of 20 minutes without CPR &#8211; and found normal LV function and elimination of ischemic insult to the brain using this technique. \u00a0\u00a0They discussed this controversial topic with Weingart on the <a href=\"http:\/\/emcrit.org\/podcasts\/future-of-cpr\/\" target=\"_blank\" rel=\"noopener\">emcrit podcast\u00a0Episode 69<\/a>.<\/li>\n<\/ul>\n<\/li>\n<li><em>Local<\/em> conditioning: applying ischemic conditioning directly to the target organ\n<ul>\n<li>Many\u00a0studies have shown effectiveness of local ischemic conditioning during PCI for acute MI. \u00a0After restoration of vessel patency, reperfusion was interrupted by cycles of 1 min of coronary balloon reocclusion. Here is a good summary:\n<ul>\n<li><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Staat-Post-Conditioning-the-Human-Heart-2005.pdf\">Staat Post-Conditioning the Human Heart 2005<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p style=\"padding-left: 60px;\"><em>\u00a0&#8220;Remote<\/em>&#8220;<em> ischemic conditioning:\u00a0<\/em>application of ischemic conditioning to a REMOTE area of the body (ie the limb) to reduce the degree of injury to the heart and brain that results from cardiac arrest (ischemia) followed by reperfusion (chest compressions, ROSC, or ECMO) by applying the\u00a0&#8216;remote&#8217; ischemia-reperfusion by using a blood pressure cuff on a limb.<\/p>\n<h4 style=\"padding-left: 30px;\">How it Works:<\/h4>\n<figure id=\"attachment_1807\" aria-describedby=\"caption-attachment-1807\" style=\"width: 740px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Lancet-figure-RIC.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1807\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Lancet-figure-RIC-740x461.png\" alt=\"*courtesy of the Lancet Vol 374; Oct 2009\" width=\"740\" height=\"461\" srcset=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Lancet-figure-RIC-740x461.png 740w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Lancet-figure-RIC-900x561.png 900w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Lancet-figure-RIC.png 1005w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/a><figcaption id=\"caption-attachment-1807\" class=\"wp-caption-text\">*courtesy of the Lancet Vol 374; Oct 2009<\/figcaption><\/figure>\n<p style=\"padding-left: 30px;\">Several theories exist to explain the benefit of ischemic conditioning. I&#8217;ll break it down in two ways:<\/p>\n<p style=\"padding-left: 60px;\">1.) \u00a0Simple explanation: &#8220;good humors&#8221; are released from the ischemic limb and protect against cell death\/apoptosis in the heart and brain.<\/p>\n<p style=\"padding-left: 60px;\">2.) Complex hypothesis:<\/p>\n<p style=\"padding-left: 90px;\">1.) RIC induces a cascade of intracellular kinases and modifies mitochondrial function within the cell by opening ATP-sensitive potassium channels and closing the mitochondrial permeability transition pore. 2.)\u00a0RIC causes release and transport of micro-RNA-144 from the ischemic limb. \u00a0Amongst other effects, miRNA-144 effevely down-regulates protein expression involved in apoptosis, autophagy, and survival signaling. Supernerds, if you really want more on this:<\/p>\n<p style=\"padding-left: 120px;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Przyklenk-Basic-Res-Cardiol-2014-RIC-microRNA.pdf\">Przyklenk Basic Res Cardiol 2014 RIC microRNA<\/a><\/p>\n<p style=\"padding-left: 120px;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/The-role-of-mitochondria-in-protection-of-the-heart-by-preconditioning-Halestrap.pdf\">role of mitochondria in protection of the heart by preconditioning Halestrap 2007<\/a><\/p>\n<h4 style=\"padding-left: 30px;\">How its Done:<\/h4>\n<ol>\n<li>On any limb, inflate a simple blood pressure cuff to a pressure above the systolic blood pressure. 200 mmHg is a good starting point. If you are using a manual cuff, Graham recommends clamping a Kelly on the tubing to prevent deflation of the cuff too soon.<\/li>\n<li>Keep the cuff inflated for 5 min and then deflate for 5 min.<\/li>\n<li>Do 3-4 cycles of this, and you&#8217;re done.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<h4 style=\"padding-left: 30px;\">The Evidence:<\/h4>\n<ol>\n<li style=\"padding-left: 60px;\">\u00a0<a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Xu-Crit-Care-Med-2015-Conditioning-in-Rat-Model-of-CA.pdf\">Xu Crit Care Med 2015 Conditioning in Rat Model of Cardiac Arrest\u00a0<\/a>\u00a0&#8211; In rats, better myocardial and cerebral function with longer duration of survival occurred when RIC was applied prior to arrest (preconditioning), at the time of arrest, or after arrest (arrest) when compared to controls (no conditioning). This take-home from this study was that the conditioning did not have to occur before the arrest; benefit was seen if conditioning were applied intra-arrest or post-arrest. \u00a0Application: RIC appears to be beneficial even if done after ROSC.<\/li>\n<li style=\"padding-left: 60px;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Sloth-Eur-Heart-J-2013-Long-Term-RIC.pdf\">Sloth Eur Heart J 2013 Long Term RIC<\/a>\u00a0&#8211; In humans, RIC before PCI improved long term clinical outcomes in patients with STEMI.<\/li>\n<li style=\"padding-left: 60px;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Rentoukas-RIC-JACC-CV-Intervention-2010.pdf\">Rentoukas RIC JACC CV Intervention 2010<\/a>\u00a0&#8211; Remote Ischemic PERI-conditioning (applying the RIC at the time of revascularization in the cath lab) was cardioprotective.<\/li>\n<li style=\"padding-left: 60px;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Przyklenk-Basic-Res-Cardiol-2014-RIC-microRNA.pdf\">Przyklenk Basic Res Cardiol 2014 RIC microRNA<\/a>\u00a0&#8211; An explanation of the proposed mechanism of RIC at the cellular level; Good Humors<\/li>\n<li style=\"padding-left: 60px;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Lancet-Botker-Ischemic-Conditioning-Trial.pdf\">Lancet Botker Ischemic Conditioning Trial<\/a>\u00a0&#8211; This is a great review paper on remote ischemic preconditioning.<\/li>\n<\/ol>\n<hr \/>\n<h3>Graham Nichol MD, MPH, FACP<\/h3>\n<figure id=\"attachment_1786\" aria-describedby=\"caption-attachment-1786\" style=\"width: 175px\" class=\"wp-caption alignright\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/nichol.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1786\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/nichol.jpg\" alt=\"Graham Nichol MD, MPH\" width=\"175\" height=\"263\" \/><\/a><figcaption id=\"caption-attachment-1786\" class=\"wp-caption-text\">Graham Nichol MD, MPH<\/figcaption><\/figure>\n<p><a href=\"mailto:nichol@uw.edu\" target=\"_blank\" rel=\"noopener\">nichol@uw.edu<\/a><\/p>\n<p>@grahamnichol<\/p>\n<h4>Current Positions:<\/h4>\n<ul>\n<li>Professor of Medicine, Division of General Internal Medicine at the University of Washington in Seattle<\/li>\n<li>Director, UW Medical Center\/Harborview Medical Center for Pre-hospital Emergency Care<\/li>\n<li>Medical Director, University of Washington Clinical Trial Center<\/li>\n<li>Leonard A Cobb Medic One Foundation Endowed Chair in Prehospital Emergency Care<\/li>\n<li>Medical Director, Resuscitation Outcome Consortium Clinical Trial Center<\/li>\n<\/ul>\n<h4>Professional Endeavors:<\/h4>\n<ul>\n<li>American Heart Association\u2019s Basic Life Support Subcommittee and Advanced Life Support Subcommittee<\/li>\n<li>chair of the Basic Life Support Subcommittee and received the American Heart Association Award of Merit<\/li>\n<li>chair of the Basic Life Support Subcommittee and received the American Heart Association Award of Merit<\/li>\n<li>Co-founded and \u00a0co-directed the Resuscitation Science Symposium (ReSS)\u00a0of the American Heart Association<\/li>\n<li>National Institutes of Health (NIH) reviewer and a grantee<\/li>\n<li>chair of the epidemiology panel for the National Heart Lung and Blood Institute-sponsored PULSE conference and PULSE leadership group<\/li>\n<li>co-principal investigator of the Resuscitation Outcomes Consortium (ROC) Data Coordinating Center<\/li>\n<li>co-investigator of the Australian Resuscitation Outcomes Consortium<\/li>\n<\/ul>\n<hr \/>\n<h3>\u00a0TrackBacks<\/h3>\n<figure id=\"attachment_1843\" aria-describedby=\"caption-attachment-1843\" style=\"width: 518px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/lifeinthefastlane.com\/litfl-review-164\/\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1843\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/LITFL-Review-5901.png\" alt=\"LITFL Reviews Episode 164\" width=\"518\" height=\"266\" \/><\/a><figcaption id=\"caption-attachment-1843\" class=\"wp-caption-text\">LITFL Reviews Episode 164<\/figcaption><\/figure>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<h3><\/h3>\n<hr \/>\n<p>&nbsp;<\/p>\n<h3>More with Graham Nichol<\/h3>\n<figure id=\"attachment_1790\" aria-describedby=\"caption-attachment-1790\" style=\"width: 740px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Death-Ride.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1790 size-medium\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Death-Ride-740x553.jpeg\" alt=\"Death Ride\" width=\"740\" height=\"553\" srcset=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Death-Ride-740x553.jpeg 740w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Death-Ride-1024x766.jpeg 1024w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Death-Ride-900x673.jpeg 900w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Death-Ride.jpeg 1280w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/a><figcaption id=\"caption-attachment-1790\" class=\"wp-caption-text\">Death Ride<\/figcaption><\/figure>\n<p style=\"padding-left: 30px;\">Graham is an avid cyclist and attributes his ability to ride more than 100 miles and climb more than 10,000 feet in a day to his off-label use of remote ischemic conditioning! \u00a0Here, he and a friend are about to begin the long ride up Carson Pass to finish the Death Ride.<\/p>\n<h3><\/h3>\n<h3>\u00a0Upcoming Events<\/h3>\n<p><a href=\"http:\/\/www.castlefest2015.com\/\" target=\"_blank\" rel=\"noopener\">CastleFest: April 14-16, 2015<\/a><\/p>\n<p><a href=\"http:\/\/www.castlefest2015.com\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1820 size-thumbnail\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.46.40-AM-150x120.png\" alt=\"Screen Shot 2015-01-05 at 1.46.40 AM\" width=\"150\" height=\"120\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"http:\/\/www.ccusinstitute.org\/\">CCUS Montreal: May 1-3, 2015<\/a><\/p>\n<p><a href=\"http:\/\/www.ccusinstitute.org\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1822 size-thumbnail\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.59.27-AM-150x87.png\" alt=\"Screen Shot 2015-01-05 at 1.59.27 AM\" width=\"150\" height=\"87\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"http:\/\/www.smacc.net.au\/about-us\/welcome\/\" target=\"_blank\" rel=\"noopener\">SMACC Chicago 2015: June 23-26, 2015<\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1821 size-thumbnail\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-150x150.png\" alt=\"Screen Shot 2015-01-05 at 1.41.16 AM\" width=\"150\" height=\"150\" srcset=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-150x150.png 150w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-144x144.png 144w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-32x32.png 32w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-64x64.png 64w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-96x96.png 96w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/Screen-Shot-2015-01-05-at-1.41.16-AM-128x128.png 128w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_1838\" aria-describedby=\"caption-attachment-1838\" style=\"width: 338px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1838 size-medium\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/edecmo_2015-Jan-04-338x600.jpg\" alt=\"Recording EDECMO 18 EDECMO World Headquarters San Diego, CA\" width=\"338\" height=\"600\" srcset=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/edecmo_2015-Jan-04-338x600.jpg 338w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/edecmo_2015-Jan-04-576x1024.jpg 576w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/edecmo_2015-Jan-04.jpg 720w\" sizes=\"(max-width: 338px) 100vw, 338px\" \/><figcaption id=\"caption-attachment-1838\" class=\"wp-caption-text\">Recording EDECMO 18<br \/>EDECMO World Headquarters<br \/>San Diego, CA<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>In this episode Zack &#038; Joe talk with Graham Nichol about how to use remote ischemic conditioning to reduce ischemia-reperfusion injury after cardiac arrest.<\/p>\n","protected":false},"author":4,"featured_media":1786,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[4],"tags":[56,116,118,117],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/01\/nichol.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p3JzC4-mM","_links":{"self":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/1412"}],"collection":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/comments?post=1412"}],"version-history":[{"count":1,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/1412\/revisions"}],"predecessor-version":[{"id":6826,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/1412\/revisions\/6826"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media\/1786"}],"wp:attachment":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media?parent=1412"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/categories?post=1412"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/tags?post=1412"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}