| Sažetak | Tourniquet, svoje začetke ima još u 16. stoljeću kada je korišten u svrhu postizanja adekvatne hemostaze. Sam naziv tourniquet (franc. 'tourner'), što znači okretati, ušao je u primjenu zahvaljujući Jean Louis Petitu. Danas se osnovna podjela tourniqueta bazira na one pneumatskog i nepneumatskog tipa, a klinička im je primjena izuzetno široka, s posebnim naglaskom na područje ortopedije, plastične i rekonstruktivne kirurgije te anesteziologije. Postokluzivna lokalna, reaktivna hiperemija fiziološka je reakcija regulirana neurovaskularnim mehanizmima, koja ovisno o trajanju okluzije može imati različite sistemske učinke: kardiovaskularne, respiratorne, cerebrovaskularne, hematološke, termoregulacijske i metaboličke. Uz to, odražava stanje mikrocirkulacije i često je pokazatelj perifernih vaskularnih bolesti. Najranije se javljaju termoregulacijske promjene, u vidu porasta temperature površine kože, koje u jednakoj mjeri, nužno ne slijedi povećanje lokalnog krvnog protoka. Metode registriranja takvih promjena su laserski doppler mjerači krvnog protoka i infracrvena termografija, koja visokom preciznošću daje prikaz distribucije i temperatura ciljanih zona reaktivne hiperemije. Ovo istraživanje je ispitalo postojanje povezanosti između različitog trajanja arterijske okluzije, na području nadlaktice i pojave reaktivne hiperemije, na distalnim dijelovima
gornjeg uda. Zajedno s time, praćena je i dinamika promjena saturacije periferne arterijske krvi kisikom i arterijskog tlaka, uzimajući u obzir varijabilnost mikrocirkulacije i anatomiju promatrane regije. Razlike izmjerenih temperatura kože prikazane su i koristeći termografsku analizu. Dosadašnje studije su pokazale dinamiku nastupa reaktivne hiperemije nakon petominutnog trajanja blijede staze na gornjem udu, bez usporedbe s duljim intervalima. |
| Sažetak (engleski) | Tourniquet was first used in the 16th century in order to achieve adequate hemostasis. The name tourniquet (French 'tourner'), which means to turn, came into use thanks to Jean Louis Petit. Today, the main classification of tourniquets is into those of pneumatic and nonpneumatic type, and their clinical application is extensive, with special emphasis on the area of orthopedics, plastic and reconstructive surgery and anesthesiology. The physiological reaction of postocclusive local reactive hyperemia is regulated by neurovascular mechanisms, which, depending on the duration of occlusion, may have different systemic effects: cardiovascular, respiratory, cerebrovascular, hematological, metabolic, and thermoregulatory. In addition, it reflects the state of the microcirculation, and is often an indicator of peripheral vascular disease. First, thermoregulatory changes occur, in the form of increased skin surface temperature, which is followed, but not necessarily, by an increase in local blood flow. Methods of registering such changes are Laser Doppler flowmetry (LDF) and infrared thermography, which provide a highly precise view of distribution and temperature target zones of reactive hyperemia. This study has investigated the association between different durations of arterial occlusion, at an area of the upper arm, and the appearance of reactive hyperemia in the distal parts of the upper limb. Besides that, dynamical changes of oxygen saturation of peripheral arterial blood and blood pressure have been studied, having in mind the variability of observed microcirculation and regional anatomy. Also, differences between measured skin temperatures are shown using thermographic analysis. Previous studies have shown dynamic performances of reactive hyperemia only after a five-minute tourniquet duration on the upper limb, without comparisons with longer intervals. |
