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Myoglobin release after tourniquet ischemia

H R Jørgensen1

  • 1Department of Orthopedics, Odense University Hospital, Denmark.

Acta Orthopaedica Scandinavica
|October 1, 1987
PubMed

Insights

Tourniquet use during surgery causes minimal myoglobin elevation after 65 minutes of ischemia. Marked increases in plasma myoglobin occur after 150 minutes, peaking 8-10 hours post-release.

Area of Science:

  • Biochemistry
  • Physiology
  • Surgical Research

Background:

  • Myoglobin is a protein found in muscle tissue.
  • Elevated plasma myoglobin can indicate muscle damage.
  • Understanding myoglobin release kinetics is crucial for monitoring ischemia.

Purpose of the Study:

  • To investigate the plasma myoglobin concentration changes following tourniquet application during elective surgery.
  • To determine the relationship between ischemia duration and myoglobin release.
  • To establish the time course of myoglobin elevation and normalization after tourniquet release.

Main Methods:

  • Plasma myoglobin levels were measured in 27 patients before and up to 68 hours after tourniquet release.
  • Patients underwent elective surgery with no skeletal muscle incision.
  • A control group had similar surgery without tourniquet use.
  • Ischemia duration ranged from 1 to 3 hours.

Main Results:

  • Minimal myoglobin elevation was observed after 65 and 90 minutes of ischemia.
  • A significant increase in myoglobin occurred after more than 150 minutes of ischemia.
  • Peak plasma myoglobin concentrations were reached 8 to 10 hours post-tourniquet release.
  • Myoglobin levels returned to preoperative values within 50 to 60 hours.

Conclusions:

  • Tourniquet-induced ischemia, even without direct muscle incision, leads to measurable myoglobin release.
  • The extent of myoglobin elevation correlates with the duration of ischemia.
  • Plasma myoglobin monitoring can provide insights into the physiological response to surgical ischemia.

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