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Title: Oxygen consumption and carbon dioxide elimination after release of unilateral lower limb pneumatic tourniquets
Authors: Lee, T.-L. 
Tweed, W.A. 
Singh, B.
Issue Date: 1992
Citation: Lee, T.-L., Tweed, W.A., Singh, B. (1992). Oxygen consumption and carbon dioxide elimination after release of unilateral lower limb pneumatic tourniquets. Anesthesia and Analgesia 75 (1) : 113-117. ScholarBank@NUS Repository.
Abstract: Oxygen consumption (V̇O 2), carbon dioxide elimination (V̇CO 2), and respiratory exchange ratio (RQ) were continuously measured in 15 male and 15 female adults during knee surgery, with the leg exsanguinated by an inflatable tourniquet around the thigh. Arterial blood was also intermittently sampled for blood gas analysis, electrolytes, and lactate content before and after tourniquet deflation. There was a significant increase in V̇O 2 and V̇CO 2 after tourniquet deflation, which was more pronounced in the male (aged 29.5 ± 14.8 yr, mean ± SD) than the female (aged 56.9 ± 15.6 yr) patients, both in terms of maximal increase (P < 0.001) and percent of increase from values before deflation (P < 0.001 and P = 0.01). The body weights and tourniquet inflation times were not significantly different between the male and female patients. Excess V̇O 2 (O 2 debt) and excess V̇CO 2 over 12 min after deflation of the tourniquet were also significantly higher for male (593.5 ± 222.9 mL and 714.9 ± 463.8 mL, respectively) than for female patients (302 ± 73.3 mL and 196 ± 162.22 mL, respectively; P < 0.01). There was no correlation between the duration of tourniquet inflation time and peak increase in V̇O 2, peak increase in V̇CO 2, and O 2 debt over 12 min after deflation of the tourniquet; however, tourniquet time was weakly correlated with excess V̇CO 2 over 12 min after tourniquet deflation (r = 0.55, P = 0.002). There was a significant decrease in pHa (P < 0.001) from release of PaCO 2 and lactate after tourniquet deflation. Plasma potassium levels also increased significantly after tourniquet release (P < 0.01). All of these biochemical changes did not cause any adverse effects in the study patients. In view of the predictable increase in V̇O 2 and V̇CO 2, we recommend monitoring of end-tidal CO 2 and a transient increase in minute ventilation to maintain normocapnea.
Source Title: Anesthesia and Analgesia
ISSN: 00032999
Appears in Collections:Staff Publications

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