Journal Article10.1111/J.1399-6576.2005.00621.X
Changes in coagulation-fibrinolysis marker and neutrophil elastase following the use of tourniquet during total knee arthroplasty and the influence of neutrophil elastase on thromboembolism.
Shinichi Katsumata,Masakazu Nagashima,Ko Kato,Akitoshi Tachihara,K. Wauke,S. Saito,Enjing Jin,Oichi Kawanami,Ryo Ogawa,Shinichi Yoshino +9 more
72
TL;DR: This work investigated whether NE played an important role in the development of PTE I a mice model and focused on the following factors: the thrombin‐antithrombin III complex (TAT), D‐dimer and neutrophil elastase (NE).
read more
Abstract: Background: To clarify in detail the mechanism underlying the development and exacerbation of deep venous thrombosis (DVT) and/or pulmonary thromboembolism (PTE), we focused on the following factors: the thrombin-antithrombin III complex (TAT), D-dimer and neutrophil elastase (NE). We basically investigated whether NE played an important role in the development of PTE I a mice model.
Methods: Nineteen rheumatoid arthritis (RA) and six osteoarthritis (OA) patients underwent total knee arthroplasty (TKA) with tourniquet, and 13 RA and 12 OA patients underwent TKA without tourniquet in each group. The blood levels of TAT, D-dimer and NE were measured before surgery, immediately after and during the days following surgery. For the induction of experimental PTE due to coagulation of platelets, adenosine diphosphate (ADP) was administrated, and human NE with ADP was also administrated for the development of DVT and/or PTE.
Results: The rates of increase in the mean TAT, D-dimer and NE levels in the group with tourniquet were statistically higher than those in the group without tourniquet after surgery. The mortality of the mouse due to PTE increased from 43 to 67% following ADP and human NE administration compared to a single ADP administration. Histological changes of the lungs in the mice receiving NE and ADP injections were characterized by a diffuse and extensive accumulation of platelets and fibrin in alveolar capillaries and other microvessels.
Conclusion: We suggest that during TKA, the use of tourniquet induces local release of a large amount of NE from neutrophils, inducing the development of DVT and/or PTE and their exacerbation.
read more
Chat with Paper
AI Agents for this Paper
Find similar papers on Google Scholar, PubMed and Arxiv
Write a critical review of this paper
Analyze citations of this paper to find unaddressed research gaps
Citations
Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial.
Jean Wong,Amir Abrishami,Hossam El Beheiry,Nizar N. Mahomed,J. Roderick Davey,Rajiv Gandhi,K. Syed,Syed Muhammad Ovais Hasan,Yoshani De Silva,Frances Chung +9 more
TL;DR: At the conclusion of a total knee arthroplasty with cement, topical application of tranexamic acid directly into the surgical wound reduced postoperative bleeding by 20% to 25%, resulting in 16% to 17% higher postoperative hemoglobin levels compared with placebo, with no clinically important increase in complications being identified in the treatment groups.
536
The effects of a tourniquet used in total knee arthroplasty: a meta-analysis
TL;DR: The meta-analysis showed that using a tourniquet in TKA could reduce intraoperative blood loss but did not decrease the calculated blood loss, which indicates the actual blood loss.
A comparison of outcomes with and without a tourniquet in total knee arthroplasty: A systematic review and meta-analysis of randomized controlled trials
Ilhan Alcelik,Raymond Pollock,Mohammed Sukeik,Josette Bettany-Saltikov,Patrick M. Armstrong,Peter Fismer +5 more
TL;DR: Of the 8 outcomes analyzed (surgery duration; total, intraoperative, and postoperative blood losses; deep vein thrombosis; pulmonary embolism; and minor/major complications), the total and intraoperativeBlood losses were less using a tourniquet.
216
Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review
Toby O. Smith,Caroline B. Hing +1 more
TL;DR: It is found that there is no advantage to using a tourniquet in knee replacement surgery for reduction of transfusion requirements.
212
References
Oxygen-derived free radicals in postischemic tissue injury.
TL;DR: It is now clear that oxygen-derived free radicals play an important part in several models of experimentally induced reperfusion injury, and Dysfunction induced by free radicals may be a major component of ischemic diseases of the heart, bowel, liver, kidney, and brain.
5.7K
Biological defense mechanisms. The production by leukocytes of superoxide, a potential bactericidal agent.
TL;DR: O(2) (-) is made by leukocytes under circumstances which suggest that it may be involved in bacterial killing, and is identified as the agent responsible for the leukocyte-mediated reduction of cytochrome c.
Elastase in Tissue Injury
TL;DR: This article surveys elastinolytic proteinases in man, excluding enzymes of the pancreas and digestive tract, with special emphasis on the elastase of polymorphonuclear neutrophils (PMN).
542
Plasma measurement of D-dimer as diagnostic aid in suspected venous thromboembolism: an overview.
TL;DR: Results show that a low concentration of plasma DD measured by the ELISA technique might be used to rule out VTE in clinically suspected patients, and the clinical usefulness of the DD ELISA test should now be assessed in management trials under routine conditions, in the frame of clinical decision-making diagnostic processes.
438