Cardiac arrest after tourniquet deflation in upper limb

Pneumatic tourniquet is a technique widely used in orthopedic surgery, in particular, for reducing intraoperative bleeding and facilitation of surgery. That said, it may cause local and systemic complications which can be life-threatening. The description of this kind of complications is usually made after lower limb utilization. We report the case of a patient, operated for fractures of the two upper limbs, who presented after the second tourniquet deflation, a cardiac arrest with a good recovery after cardio-pulmonary resuscitation. The most likely cause of this cardiac arrest, is the ischemia reperfusion syndrome caused by successive excessively inflated tourniquet, since pulmonary embolism and myocardial infarction are eliminated. In the light of this exceptional clinical observation, we insist on the respect of usual recommendations of use, such as duration and inflation pressure, especially when successive upper limbs tourniquets are used.