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Physiologic changes during tourniquet use in children
M Goodarzi1, N H Shier, J A Ogden
1Shriners Hospital for Crippled Children, Tampa, Florida 33612.
Insights
Unilateral tourniquet use in children can cause significant physiological changes. Longer tourniquet application times (over 75 minutes) are associated with increased body temperature, heart rate, and lactate levels.
Area of Science:
- Pediatric surgery
- Anesthesiology
- Physiology
Background:
- Tourniquet use is common in pediatric surgery.
- Hemodynamic and metabolic effects require further understanding.
Purpose of the Study:
- To assess hemodynamic and metabolic effects of unilateral tourniquet use in children.
- To identify factors influencing these effects.
Main Methods:
- 30 children undergoing unilateral tourniquet application.
- Measurement of intraoperative temperature, pulse rate, end-tidal CO2, and lactate.
- Comparison of pre- and post-inflation values.
Main Results:
- Maximum changes in temperature and pulse rate observed with tourniquet times > 75 minutes.
- Significant increases in lactate and end-tidal CO2 in the same patient group.
- Individual variability in response noted.
Conclusions:
- Tourniquet application duration impacts physiological responses in children.
- Close monitoring of hemodynamics and metabolism is crucial during prolonged tourniquet use.
- Further research needed to optimize tourniquet protocols in pediatric patients.
Abstract:
The hemodynamic and metabolic effects of unilateral tourniquet use were assessed in 30 children. Intraoperative hyperthermia, tachycardia, endtidal CO2, and lactic acid concentration were measured before and after tourniquet inflation. Maximum changes in temperature and pulse rate occurred in patients who had tourniquet application time lasting greater than 75 min. Lactate and endtidal CO2 levels were also significantly increased in the same group of patients.