Intravascular coagulation and fibrinolysis within primate extremities during tourniquet ischemia

S. H. Miller, M. E. Eyster, A. Saleem, L. Gottleib, D. Buck, W. P. Graham IIIrd

    Research output: Contribution to journalArticlepeer-review

    9 Scopus citations

    Abstract

    A common although infrequently recognized complication associated with the use of a pneumatic tourniquet is profuse bleeding from the wound after deflation of the tourniquet. The purpose of this study was to determine whether intravascular coagulation and fibrinolysis could be induced in sub-human primates by tourniquet ischemia, and whether this phenomenon could be altered by pretreatment of the animal with heparin. It was shown that, after 2 1/2 hours of tourniquet ischemia, (400 mmHg) to one lower limb, fibrinogen levels were significantly lower (p < .005), antithrombin III levels were significantly lower (p < .05), plasminogen levels were significantly lower (p < .05), fibrin split products significantly higher (p <.025) and fibrinopeptide A levels were significantly higher (p < .02) than values measured simultaneously in the control limbs. After pre-treatment with sodium heparin, 30 units/kg, there was no change in antithrombin III levels or fibrinogen levels, but fibrin split products in the experimental limbs were significantly elevated (p < .05) when compared to control limbs. In both groups the abnormal levels returned to control levels 5-30 minutes after tourniquet deflation. We conclude that intravascular coagulation and fibrinolysis develop within ischemic subhuman primate limbs during tourniquet ischemia. Pretreatment with heparin prevents the consumption of fibrinogen and antithrombin III but does not prevent the increase in fibrin split products which was observed. It is possible that intravascular coagulation and fibrinolysis contribute to post tourniquet bleeding.

    Original languageEnglish (US)
    Pages (from-to)227-230
    Number of pages4
    JournalUnknown Journal
    Volume190
    Issue number2
    DOIs
    StatePublished - 1979

    All Science Journal Classification (ASJC) codes

    • Surgery

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