Tourniquet-induced systemic inflammatory response in extremity surgery.
AffiliationDepartment of Academic Surgery, Cork University Hospital, Cork, Ireland.
Analysis of Variance
*Arthroplasty, Replacement, Knee
Cell Migration Inhibition
Systemic Inflammatory Response Syndrome/blood/*etiology
MetadataShow full item record
CitationJ Trauma. 2001 Nov;51(5):922-6.
JournalThe Journal of trauma
AbstractBACKGROUND: Tourniquet-induced reperfusion injury in animals produces significant systemic inflammatory effects. This study investigated whether a biologic response occurs in a clinically relevant model of tourniquet-induced reperfusion injury. METHODS: Patients undergoing elective knee arthroscopy were prospectively randomized into controls (no tourniquet) and subjects (tourniquet-controlled). The effects of tourniquet-induced reperfusion on monocyte activation state, neutrophil activation state, and transendothelial migration (TEM) were studied. Changes in the cytokines implicated in reperfusion injury, tumor necrosis factor-alpha, interleukin (IL)-1beta, and IL-10 were also determined. RESULTS: After 15 minutes of reperfusion, neutrophil and monocyte activation were significantly increased. Pretreatment of neutrophils with pooled subject (ischemia-primed) plasma significantly increased TEM. In contrast, TEM was not significantly altered by ischemia-primed plasma pretreatment of the endothelial monolayer. Significant elevation of tumor necrosis factor-alpha and IL-1beta were observed in subjects compared with controls after 15 minutes of reperfusion. There was no significant difference in serum IL-10 levels between the groups at all the time points studied. CONCLUSION: These results indicate a transient neutrophil and monocyte activation after tourniquet-ischemia that translates into enhanced neutrophil transendothelial migration with potential for tissue injury.
- Ischemic preconditioning attenuates pulmonary dysfunction after unilateral thigh tourniquet-induced ischemia-reperfusion.
- Authors: Lin LN, Wang LR, Wang WT, Jin LL, Zhao XY, Zheng LP, Jin LD, Jiang LM, Xiong XQ
- Issue date: 2010 Aug
- The effect of lidocaine on in vitro neutrophil and endothelial adhesion molecule expression induced by plasma obtained during tourniquet-induced ischaemia and reperfusion.
- Authors: Lan W, Harmon D, Wang JH, Ghori K, Shorten G, Redmond P
- Issue date: 2004 Nov
- Cytokines and adhesion molecules in elective and accidental trauma-related ischemia/reperfusion.
- Authors: Seekamp A, Jochum M, Ziegler M, van Griensven M, Martin M, Regel G
- Issue date: 1998 May
- Pulmonary gas exchange impairment following tourniquet deflation: a prospective, single-blind clinical trial.
- Authors: Lin L, Wang L, Bai Y, Zheng L, Zhao X, Xiong X, Jin L, Ji W, Wang W
- Issue date: 2010 Jun 9
- The role of preconditioning and N-acetylcysteine on oxidative stress resulting from tourniquet-induced ischemia-reperfusion in arthroscopic knee surgery.
- Authors: Koca K, Yurttas Y, Cayci T, Bilgic S, Kaldirim U, Durusu M, Cekli Y, Ozkan H, Hanci V, Purtuloglu T, Akgul EO, Oguz E, Yildiz C, Basbozkurt M
- Issue date: 2011 Mar