Mild episodes of tourniquet-induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers

Abstract

Background: Monocytes and neutrophils are examples of phagocytic leukocytes, with neutrophils being considered as the 'chief' phagocytic leukocyte. Both monocytes and neutrophils have been implicated to play a key role in the development of ischaemia-reperfusion injury, where they are intrinsically involved in leukocyte-endothelial cell interactions. In this pilot study we hypothesised that mild episodes of tourniquet induced forearm ischaemia-reperfusion injury results in leukocyte activation and changes in inflammatory and coagulation markers.

The effects of general and spinal anesthesia on systemic inflammatory response in patients undergoing total knee arthroplasty

“…[19] Tourniquet use may result in skeletal muscle ischemia-reperfusion injury, and thus increase the SIR to surgery. [20,21] However, the mean time for tourniquet use were similar between the groups in this study.…”

Effects of colloid solutions on ischemia-reperfusion-induced periosteal microcirculatory and inflammatory reactions: Comparison of dextran, gelatin, and hydroxyethyl starch*

“…However, it has subsequently been clarified that, although PMN adhesion to ICAM-1 is primarily CD11a-dependent, it is stabilized and promoted by CD11b (30). CD11b is transferred to the cell surface from preformed intracellular pools; and its expression on circulating PMNs is increased several-fold in response to different stimuli, including local I-R injury (31,32). Although the causal link between local and systemic inflammatory events usually remains uncertain, changes in CD11b expression level could also relate to the global status of PMN activation (31).…”

Does Limb Preconditioning Reduce Pain After Total Knee Arthroplasty? A Randomized, Double-blind Study

“…Although evidence is emerging that even mild episodes of limb ischemia might elicit pathologic changes like increased leukocyte adhesiveness, endothelial damage, and activation of a procoagulatory state with possible risk of thrombogenesis [10], the clinical relevance of these findings remains unknown. In a recent clinical study, Reikerås et al found significant local thrombogenic and fibrinolytic activity in the operative leg after tourniquet deflation but no significant systemic impact [18].…”

“…Although we hypothesized that preconditioning may positively influence the level of local inflammation at the site of surgery as suggested by previous experimental evidence [15], no such data were available from our study at the time. Moreover, changes in systemic levels of coagulation activity were not measured in this study, and there is conflicting evidence about the systemic impact of tourniquet maneuvers on coagulation status [10,18].…”