Abstract Number: PB0418
Meeting: ISTH 2021 Congress
Background: Despite the pervasive use of tourniquets in major orthopedic surgeries, its effectiveness and associated complications remains a controversial topic. Our previous study has shown prolonged tourniquet application in the hind limb of rats to be associated with elevated D-Dimer (DD) levels. Tourniquets are effective in controlling intraoperative blood loss. However, complications such as thromboembolic events, with a symptomatic incidence of ~10%, are a major postoperative complication for patients associated with increased morbidity and mortality.
Aims: To evaluate the effects of prolonged tourniquet application on hematologic parameters such as Von Willebrand factor (VWF), tissue plasminogen activator (TPA) and DD, in Sprague Dawley Rats (SD).
Methods: Male SD rats weighing ~325g were anesthetized under isoflurane. Experimental animals (n=4) received a tourniquet standardized to 38 newtons for 3-hours around the hind-leg, at the proximal femur. Control animals (n=4) did not receive tourniquet application. After 3 hours, the tourniquet was removed on experimental animals and blood was collected from the tail vein of all subjects. All parameters were measured using respective Asserachrom antigenic kits (Diagnostic Stago), an enzyme immunoassay by ELISA method.
Results: The experimental animals demonstrated elevated levels of DD, VWF and TPA. The mean DD value for experimental and control animals was 289.3 ng/mL and 67.37 ng/mL, respectively (P=0.0035). The mean TPA value for experimental and control animals was 11.4 ng/mL and 1.0 ng/mL, respectively (P=0.0005). The mean VWF value for experimental and control animals was 3.4% and 2.9%, respectively (P=0.19).
Conclusions: The significant elevations in TPA and DD suggest the activation of the fibrinolytic system in animals receiving prolonged tourniquet application. This animal model aligns with our previous work to suggest the direct effects of tourniquet application on activation of the coagulation cascade. Further research is required to study the pathophysiology and development of venous thromboembolic events, using diagnostic imaging methods, following prolonged tourniquet application.
To cite this abstract in AMA style:Chung J, Mian O, Chan AK, Matino D. Prolonged Tourniquet Application in the Hind Limb of Rats Is Associated with Fibrinolysis [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/prolonged-tourniquet-application-in-the-hind-limb-of-rats-is-associated-with-fibrinolysis/. Accessed November 29, 2021.
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