Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial

Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless sur...
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Autor*in:	Kim, Tae Kyun [verfasserIn] Bamne, Ankur B. Sim, Jae Ang Park, Ji Hyeon Na, Young Gon

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Knee Arthroplasty Tourniquet Inflation pressure Complication

Anmerkung:	© The Author(s). 2019

Übergeordnetes Werk:	Enthalten in: BMC musculoskeletal disorders - London : BioMed Central, 2000, 20(2019), 1 vom: 04. Juni
Übergeordnetes Werk:	volume:20 ; year:2019 ; number:1 ; day:04 ; month:06

Links:	Volltext

DOI / URN:	10.1186/s12891-019-2636-7

Katalog-ID:	SPR028055578

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245	1	0	\|a Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial
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520			\|a Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013.
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allfields	10.1186/s12891-019-2636-7 doi (DE-627)SPR028055578 (SPR)s12891-019-2636-7-e DE-627 ger DE-627 rakwb eng Kim, Tae Kyun verfasserin aut Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2019 Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. Knee (dpeaa)DE-He213 Arthroplasty (dpeaa)DE-He213 Tourniquet (dpeaa)DE-He213 Inflation pressure (dpeaa)DE-He213 Complication (dpeaa)DE-He213 Bamne, Ankur B. aut Sim, Jae Ang aut Park, Ji Hyeon aut Na, Young Gon (orcid)0000-0003-2723-4328 aut Enthalten in BMC musculoskeletal disorders London : BioMed Central, 2000 20(2019), 1 vom: 04. Juni (DE-627)326643745 (DE-600)2041355-5 1471-2474 nnns volume:20 year:2019 number:1 day:04 month:06 https://dx.doi.org/10.1186/s12891-019-2636-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2019 1 04 06
spelling	10.1186/s12891-019-2636-7 doi (DE-627)SPR028055578 (SPR)s12891-019-2636-7-e DE-627 ger DE-627 rakwb eng Kim, Tae Kyun verfasserin aut Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2019 Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. Knee (dpeaa)DE-He213 Arthroplasty (dpeaa)DE-He213 Tourniquet (dpeaa)DE-He213 Inflation pressure (dpeaa)DE-He213 Complication (dpeaa)DE-He213 Bamne, Ankur B. aut Sim, Jae Ang aut Park, Ji Hyeon aut Na, Young Gon (orcid)0000-0003-2723-4328 aut Enthalten in BMC musculoskeletal disorders London : BioMed Central, 2000 20(2019), 1 vom: 04. Juni (DE-627)326643745 (DE-600)2041355-5 1471-2474 nnns volume:20 year:2019 number:1 day:04 month:06 https://dx.doi.org/10.1186/s12891-019-2636-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2019 1 04 06
allfields_unstemmed	10.1186/s12891-019-2636-7 doi (DE-627)SPR028055578 (SPR)s12891-019-2636-7-e DE-627 ger DE-627 rakwb eng Kim, Tae Kyun verfasserin aut Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2019 Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. Knee (dpeaa)DE-He213 Arthroplasty (dpeaa)DE-He213 Tourniquet (dpeaa)DE-He213 Inflation pressure (dpeaa)DE-He213 Complication (dpeaa)DE-He213 Bamne, Ankur B. aut Sim, Jae Ang aut Park, Ji Hyeon aut Na, Young Gon (orcid)0000-0003-2723-4328 aut Enthalten in BMC musculoskeletal disorders London : BioMed Central, 2000 20(2019), 1 vom: 04. Juni (DE-627)326643745 (DE-600)2041355-5 1471-2474 nnns volume:20 year:2019 number:1 day:04 month:06 https://dx.doi.org/10.1186/s12891-019-2636-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2019 1 04 06
allfieldsGer	10.1186/s12891-019-2636-7 doi (DE-627)SPR028055578 (SPR)s12891-019-2636-7-e DE-627 ger DE-627 rakwb eng Kim, Tae Kyun verfasserin aut Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2019 Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. Knee (dpeaa)DE-He213 Arthroplasty (dpeaa)DE-He213 Tourniquet (dpeaa)DE-He213 Inflation pressure (dpeaa)DE-He213 Complication (dpeaa)DE-He213 Bamne, Ankur B. aut Sim, Jae Ang aut Park, Ji Hyeon aut Na, Young Gon (orcid)0000-0003-2723-4328 aut Enthalten in BMC musculoskeletal disorders London : BioMed Central, 2000 20(2019), 1 vom: 04. Juni (DE-627)326643745 (DE-600)2041355-5 1471-2474 nnns volume:20 year:2019 number:1 day:04 month:06 https://dx.doi.org/10.1186/s12891-019-2636-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2019 1 04 06
allfieldsSound	10.1186/s12891-019-2636-7 doi (DE-627)SPR028055578 (SPR)s12891-019-2636-7-e DE-627 ger DE-627 rakwb eng Kim, Tae Kyun verfasserin aut Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2019 Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. Knee (dpeaa)DE-He213 Arthroplasty (dpeaa)DE-He213 Tourniquet (dpeaa)DE-He213 Inflation pressure (dpeaa)DE-He213 Complication (dpeaa)DE-He213 Bamne, Ankur B. aut Sim, Jae Ang aut Park, Ji Hyeon aut Na, Young Gon (orcid)0000-0003-2723-4328 aut Enthalten in BMC musculoskeletal disorders London : BioMed Central, 2000 20(2019), 1 vom: 04. Juni (DE-627)326643745 (DE-600)2041355-5 1471-2474 nnns volume:20 year:2019 number:1 day:04 month:06 https://dx.doi.org/10.1186/s12891-019-2636-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 20 2019 1 04 06
language	English
source	Enthalten in BMC musculoskeletal disorders 20(2019), 1 vom: 04. Juni volume:20 year:2019 number:1 day:04 month:06
sourceStr	Enthalten in BMC musculoskeletal disorders 20(2019), 1 vom: 04. Juni volume:20 year:2019 number:1 day:04 month:06
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Knee Arthroplasty Tourniquet Inflation pressure Complication
isfreeaccess_bool	true
container_title	BMC musculoskeletal disorders
authorswithroles_txt_mv	Kim, Tae Kyun @@aut@@ Bamne, Ankur B. @@aut@@ Sim, Jae Ang @@aut@@ Park, Ji Hyeon @@aut@@ Na, Young Gon @@aut@@
publishDateDaySort_date	2019-06-04T00:00:00Z
hierarchy_top_id	326643745
id	SPR028055578
language_de	englisch
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A prospective randomized controlled trial</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2019</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s). 2019</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. 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author	Kim, Tae Kyun
spellingShingle	Kim, Tae Kyun misc Knee misc Arthroplasty misc Tourniquet misc Inflation pressure misc Complication Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial
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topic_title	Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial Knee (dpeaa)DE-He213 Arthroplasty (dpeaa)DE-He213 Tourniquet (dpeaa)DE-He213 Inflation pressure (dpeaa)DE-He213 Complication (dpeaa)DE-He213
topic	misc Knee misc Arthroplasty misc Tourniquet misc Inflation pressure misc Complication
topic_unstemmed	misc Knee misc Arthroplasty misc Tourniquet misc Inflation pressure misc Complication
topic_browse	misc Knee misc Arthroplasty misc Tourniquet misc Inflation pressure misc Complication
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title	Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial
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title_full	Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial
author_sort	Kim, Tae Kyun
journal	BMC musculoskeletal disorders
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author_browse	Kim, Tae Kyun Bamne, Ankur B. Sim, Jae Ang Park, Ji Hyeon Na, Young Gon
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title_sort	is lower tourniquet pressure during total knee arthroplasty effective? a prospective randomized controlled trial
title_auth	Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial
abstract	Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. © The Author(s). 2019
abstractGer	Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. © The Author(s). 2019
abstract_unstemmed	Background Higher tourniquet pressures may be associated with an increased risk of complications. We aimed to determine (1) whether a lower tourniquet pressure [systolic blood pressure (SBP) + 120 mmHg] is as effective as conventional tourniquet pressure (SBP + 150 mmHg) in providing a bloodless surgical field and decreasing blood loss, and (2) whether lowering the tourniquet pressure decreases tourniquet-related complications compared to conventional inflation pressure. Methods One hundred and sixty knees in 124 patients undergoing total knee arthroplasty (TKA) were randomly allocated to either conventional (n = 80) or lower inflation pressure group (n = 80). The quality of the initial surgical field and occurrence of intraoperative blood oozing, hemoglobin drop, drained volume and calculated blood loss were assessed as efficacy variables. Safety outcome variables included post-operative pain, tourniquet site skin problems (ecchymosis, bullae, skin necrosis), and other tourniquet-related complications such as nerve palsy, venous thromboembolism, and delayed rehabilitation. Results A comparable bloodless surgical field was successfully provided in both groups (100% vs. 99%, p = 1.000). One case in the conventional pressure group and two cases in the lower pressure group showed intraoperative blood oozing (p = 1.000), which was successfully controlled after an increase of 30 mmHg in the tourniquet inflation pressure. There was no difference in the hemoglobin drop, drained volume, and calculated blood loss. The two groups did not differ in any safety outcomes such as post-operative pain, thigh complications, and other tourniquet related complications. Conclusion This study demonstrates that a tourniquet inflation pressure of 120 mmHg above the SBP is effective method during TKA. Trial registration The trial was with ClinicalTrials.gov (NCT01993758) on November 25, 2013. © The Author(s). 2019
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title_short	Is lower tourniquet pressure during total knee arthroplasty effective? A prospective randomized controlled trial
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author2	Bamne, Ankur B. Sim, Jae Ang Park, Ji Hyeon Na, Young Gon
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