Hemodynamic and oxidative mechanisms of tourniquet-induced muscle injury: near-infrared spectroscopy for the orthopedics setting

During orthopedic procedures, the tourniquets used to maintain bloodless surgical fields cause ischemia and then reperfusion (I/R), leading to oxidative muscle injury. Established methods exist neither for monitoring orthopedic I/R nor for predicting the extent of tourniquet-associated oxidative inj...

Full description

Saved in:
Bibliographic Details
Published in:Journal of Biomedical Optics 2012-08, Vol.17 (8), p.081408-1-081408-3
Main Authors: Shadgan, Babak, Reid, W. Darlene, Harris, R. Luke, Jafari, Siavash, Powers, Scott K, O'Brien, Peter J
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - analysis
Biomarkers - metabolism
Correlation
Female
hemodynamics, ischemia-reperfusion injury
Humans
Injuries
Ischemia
Ischemia - metabolism
Male
Middle Aged
muscle protein oxidation
Muscle Proteins - analysis
Muscle Proteins - metabolism
Muscle, Skeletal - blood supply
Muscle, Skeletal - injuries
Muscle, Skeletal - metabolism
Muscles
near-infrared spectroscopy
Orthopedics
Oxidation
Oxidation-Reduction
Proteins
Reproducibility of Results
Sensitivity and Specificity
Spectroscopy, Near-Infrared - methods
tourniquet
Tourniquets
Tourniquets - adverse effects
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:During orthopedic procedures, the tourniquets used to maintain bloodless surgical fields cause ischemia and then reperfusion (I/R), leading to oxidative muscle injury. Established methods exist neither for monitoring orthopedic I/R nor for predicting the extent of tourniquet-associated oxidative injury. To develop a predictive model for tourniquet-associated oxidative muscle injury, this study combined real-time near-infrared spectroscopy (NIRS) monitoring of I/R with Western blotting (WB) for oxidized proteins. We hypothesized strong correlations between NIRS-derived I/R indices and muscle protein oxidation. In 17 patients undergoing ankle fracture repair, a thigh tourniquet was inflated on the injured limb (300 mmHg). Using a continuous-wave (CW) NIRS setup, oxygenated ( ), deoxygenated (HHb), and total (tHb) hemoglobin were monitored bilaterally (tourniquet versus control) in leg muscles. Leg muscle biopsies were collected unilaterally (tourniquet side) immediately after tourniquet inflation (pre) and before deflation (post). Average ischemia duration was . In post-compared to pre-biopsies, muscle protein oxidation (quantified using WB) increased ( ). Changes in and tHb were negatively correlated with protein oxidation (respectively: , and , ). Reoxygenation rate was positively correlated with protein oxidation ( , ). These data indicate that using CW NIRS, it is possible to predict orthopedic tourniquet-associated muscle oxidative injury noninvasively.
ISSN:1083-3668
1560-2281
DOI:10.1117/1.JBO.17.8.081408