Cardiac arrest after tourniquet deflation in upper limb

Zarrouki, Youssef; Abouelhassan, T.; Samkaoui, M.A.

doi:10.1016/j.tcr.2017.01.001

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…There was no significant difference between the two groups regarding MAP before deflation. Nevertheless, group 1 showed significantly higher MAP compared to group 2 after deflation [p < 0.001] [ Table [2]: Heart rate variation before and after tourniquet deflation in the studied groups.…”

Section: Resultsmentioning

confidence: 99%

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Comparison between the Effect of Trendelenburg 20 Degree and Straight Leg Raising 45 Degree Positions on The Hemodynamics After Tourniquet Deflation in Knee Arthroscopy

sonbol

Ghareeb

2021

International Journal of Medical Arts

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Background: Deflation of the pneumatic tourniquet after orthopedic surgery is associated with multiple cardiovascular adverse effects [hypotension and tachycardia]. Trendelenburg position or passive leg raising [PLR] are commonly used as the initial treatment of shock and hypotension Aim of the work: To compare between Trendelenburg position 20˚ and passive leg raising 45° regarding the incidence of posttourniquet deflation cardiovascular adverse effects in patients undergoing unilateral knee arthroscopy. Patients and methods: This prospective study included 98 cases that underwent unilateral knee arthroscopy. Patients were randomly allocated into two groups; group [1] included 49 cases who were exposed to the Trendelenburg position after deflation, and group [2] included the remaining cases who had the straight leg raising test after deflation. Mean arterial pressure, heart rate, and need for vasoactive substances were recorded.Results: No significant difference was noticed between the two groups regarding demographic variables, heart rate before tourniquet deflation, and one-minute after its deflation. However, there was a significant difference between the same groups on the subsequent readings apart from the last one. Also, group [1] showed significantly higher mean arterial pressure [MAP] compared to group [2] after deflation. Hypotension was more significantly encountered in group [2], and thus ephedrine requirements were increased. Conclusion:Trendelenburg position appears to be more efficacious when compared to the straight leg raising, regarding the prevention of cardiovascular adverse effects associated with deflation.

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Section: Resultsmentioning

confidence: 99%

“…Hemodynamic changes after tourniquet deflation include; hypotension, tachycardia and increase in cardiac index [2] . These changes may be insignificant for healthy individuals but, risky for patients with compromised cardiovascular system and geriatric population [2,3] .…”

Section: Introductionmentioning

confidence: 99%

Comparison between the Effect of Trendelenburg 20 Degree and Straight Leg Raising 45 Degree Positions on The Hemodynamics After Tourniquet Deflation in Knee Arthroscopy

sonbol

Ghareeb

2021

International Journal of Medical Arts

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“…An artery and vein can be controlled for a set amount of time with the use of a tourniquet, which is a device that compresses or narrows an extremity [1] . When a tourniquet is deflated, it can cause changes in hemodynamics, such as low blood pressure, rapid heart rate, and an elevated cardiac index [2] . People whose cardiovascular systems are healthy may not notice these changes, but those with impaired cardiovascular function or who are elderly may be at danger [2,3] .…”

Section: Introductionmentioning

confidence: 99%

“…When a tourniquet is deflated, it can cause changes in hemodynamics, such as low blood pressure, rapid heart rate, and an elevated cardiac index [2] . People whose cardiovascular systems are healthy may not notice these changes, but those with impaired cardiovascular function or who are elderly may be at danger [2,3] . A growing body of research suggests that norepinephrine, a classic vasopressor, could be an effective alternative to other methods for treating or avoiding hypotension [4] .…”

Section: Introductionmentioning

confidence: 99%

Noradrenaline versus glypressin for prevention of hypotension after deflation of tourniquet in knee arthroplasty

Eid,

Mostafa,

Abdelrahman

et al. 2024

Int. J. Med. Anesthesiology

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Hypotension, rapid heart rate, and an increased cardiac index are hemodynamic disturbances that can be triggered by a tourniquet's deflation. Patients with impaired cardiovascular function and the elderly are at increased risk due to these changes, even though they may not be noticeable to those with healthy cardiovascular systems. Vasopressor medications work by reversing the effects of sympathetic blockage on the blood vessels. As a result of their actions, venous return and heart filling are preserved and vascular tone is restored. An effective method for managing spinal hypotension is the administration of vasopressors, either by bolus injections or continuous infusion. Researchers are interested in studying the efficacy and safety profiles of norepinephrine and glypressin since they have gained increased attention as possible alternatives for the prevention and treatment of hypotensive episodes.

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“…Tourniquet deflation is a critical stage because it causes a sudden drop in central venous pressure, mean arterial pressure (MAP) and HR variability. Cardiac arrests have been reported following cuff deflation [4,5].…”

Section: Introductionmentioning

confidence: 99%

Gradual versus intermittent release of tourniquet in total knee arthroplasty surgery, effects on hemodynamics and acid base parameters: a prospective randomized controlled study

Elbadrawy

Aboelela

2021

Egyptian Journal of Anaesthesia

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Background: Using of the pneumatic tourniquet is a common practice in many surgeries. While it creates bloodless field, it is not free of complications. Tourniquet deflation is a critical stage, greatly affecting hemodynamics. Till now, no strict guidelines have been developed for managing such a procedure. Methods: Sixty patients, >40 years old, undergoing total knee arthroplasty enrolled in this study. Tourniquet deflation done over 3 min before complete release, either by gradual pressure release 50 mmHg/30 s in gradual deflation (G) group or by three cycles of deflationreinflation (deflation for 10 s and reinflation for 50 s) in intermittent deflation (I) group. Results: No significant difference was found regarding patient demographics and basal data. Mean arterial pressure was significantly lower in G group at times of deflation and post deflation for 5 min (P values 0.011, 0.023, 0.024, 0.001, and 0.013, respectively). Also, heart rate and acid base parameters were more stable and convergent to basal data in I group. Conclusion:Compared to gradual deflation, intermittent deflation of tourniquet in middle and old aged, total knee arthroplasty patients resulted in more stability in hemodynamics and acid base parameters.

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Cardiac arrest after tourniquet deflation in upper limb

Cited by 6 publications

References 2 publications

Comparison between the Effect of Trendelenburg 20 Degree and Straight Leg Raising 45 Degree Positions on The Hemodynamics After Tourniquet Deflation in Knee Arthroscopy

Comparison between the Effect of Trendelenburg 20 Degree and Straight Leg Raising 45 Degree Positions on The Hemodynamics After Tourniquet Deflation in Knee Arthroscopy

Noradrenaline versus glypressin for prevention of hypotension after deflation of tourniquet in knee arthroplasty

Gradual versus intermittent release of tourniquet in total knee arthroplasty surgery, effects on hemodynamics and acid base parameters: a prospective randomized controlled study

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