| Quantification and comparison of pulmonary emboli formation after pneumatic tourniquet release in patients undergoing reconstruction of anterior cruciate ligament and total knee arthroplasty. | |
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MedLine Citation:
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PMID: 12032043 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The amount of emboli formed (percentage of total emboli area to the right atrial area [%Ae]) after tourniquet release in invasive procedures of the medullary cavity is empirically much larger than that in noninvasive procedures, even if the tourniquet duration is similar. Thus, we compared %Ae between arthroscopic reconstruction of the anterior cruciate ligament (ACL, n = 20) and total knee arthroplasty (TKA, n = 20). The right atrium was continuously monitored by transesophageal echocardiography to assess %Ae. Peak %Ae +/- SD (ACL, 4.1% +/- 3.4%; TKA, 20.7% +/- 16.7%) appeared 30-40 s after tourniquet release in both groups. However, %Ae in the TKA group was always larger than the peak %Ae in the ACL group. In addition, although the ET(CO(2)) significantly increased after tourniquet release in both groups, increase of ET(CO(2)) (1.1% +/- 0.3%) in the ACL group was significantly larger than that in the TKA group (0.5% +/- 0.2%). An increase in ET(CO(2)) was inversely proportional to peak %Ae (P < 0.01; r = 0.703). Therefore, the present data suggest that the risk of acute pulmonary embolism after tourniquet release may be more frequent during TKA than ACL. IMPLICATIONS: We compared emboli formation after tourniquet release in patients undergoing arthroscopic reconstruction of the anterior cruciate ligament (ACL, n = 20) and total knee arthroplasty (TKA, n = 20) using transesophageal echocardiography. The present data suggest that the risk of acute pulmonary embolism after tourniquet release could be more frequent during TKA than ACL. |
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Authors:
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Kazuyoshi Hirota; Hiroshi Hashimoto; Toshihito Tsubo; Hironori Ishihara; Akitomo Matsuki |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 94 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 2002 Jun |
Date Detail:
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Created Date: 2002-05-28 Completed Date: 2002-06-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1633-8, table of contents Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki 036-8562, Japan. masuika@cc.hirosaki-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Aged, 80 and over Anterior Cruciate Ligament / surgery* Arthroplasty, Replacement, Knee / adverse effects* Atrial Function, Right Echocardiography, Transesophageal Female Hemodynamics / physiology Humans Intraoperative Complications / epidemiology*, etiology Male Orthopedic Procedures / adverse effects* Oxygen / blood Pulmonary Embolism / epidemiology*, etiology Reperfusion / adverse effects* Tourniquets / adverse effects* |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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