title: Technique for Measuring Limb Occlusion Pressure that Facilitates Personalized Tourniquet Systems: A Randomized Trial.
abstract: We developed a technique for measuring patient limb occlusion pressure (LOP) through a tourniquet cuff that overcomes many limitations of existing LOP measurement techniques. The purpose of the study is to determine whether the LOP measured by the proposed technique is statistically or clinically different from that measured by the gold standard Doppler ultrasound technique. The study used randomized crossover multicenter trials. 143 pre- and post-surgical patients with a mean age of 54 years (range 17-86 years) were enrolled in the study. Pneumatic cuffs were applied to the non-operative upper and lower limbs and LOP was measured using the proposed technique and the Doppler ultrasound technique. From a total of 252 usable measurements for each technique (134 for upper limbs and 118 for lower limbs), the mean difference in LOP between the two techniques was 1 ± 8 mmHg for the upper limbs, 0 ± 15 mmHg for the lower limbs, and 1 ± 12 mmHg overall. The differences between the proposed technique and the Doppler technique were neither statistically nor clinically significant. The simplicity, effectiveness, and accuracy of the proposed technique should lead to broader clinical usage and acceptance of LOP measurement, thus leading to safer, personalized pressures in surgical tourniquet applications.
authors.affiliation: Department of Orthopaedics, University of British Columbia, 3114 - 910 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada.
authors.forename: Bassam A
authors.initials: BA
authors.lastname: Masri
authors.affiliation: Department of Orthopaedics, University of British Columbia, 3114 - 910 West 10th Avenue, Vancouver, BC V5Z 1M9 Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Day
authors.affiliation: Department of Orthopaedics, University of British Columbia, 560 1144 Burrard Street, Vancouver, BC V6Z 2A5 Canada.
authors.forename: Alastair S E
authors.initials: AS
authors.lastname: Younger
authors.affiliation: Western Clinical Engineering, 207-1099 West 8th Avenue, Vancouver, BC V6H 1C3 Canada.
authors.forename: Jeswin
authors.initials: J
authors.lastname: Jeyasurya
keywords: Limb occlusion pressure; Personalized; Tourniquet; Tourniquet injury; Tourniquet safety