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Development of adaptive pneumatic tourniquet systems based on minimal inflation pressure for upper limb surgeries

机译：基于最小充气压力的上肢手术自适应气压止血带系统的开发

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Background Pneumatic tourniquets are medical devices that occlude blood flow to distal part of extremities and are commonly used in upper limb surgeries to provide a dry, clean and bloodless field. To decrease pressure-related injuries and potential risk of complications subjected to the high inflation pressure of pneumatic tourniquet, minimal inflation pressures are recommended. Methods A new occlusion pressure mathematical model for the upper limb was established based on the correlation analysis between several possible influencing parameters and the minimal pneumatic tourniquet pressure at which the peripheral pulse disappeared was recorded using a digital plethysmograph. A prototype of an adaptive pneumatic tourniquet which automatically varies the pressure in the tourniquet cuff according to the above prediction model was developed for the upper limb which used the lowest possible inflation pressure to achieve occlusion. The prototype comprises a blood pressure monitoring module, an inflatable tourniquet cuff, and a pressure relief mechanism to maintain an optimal cuff inflation pressure. Simulation experiments were conducted to verify the function and stability of the designed adaptive pneumatic tourniquet and clinical experiments using volunteers were undertaken to evaluate the performance of the prototype design in achieving adequate haemostasis in the upper limb. Results Results demonstrated that the mean arterial occlusion pressure was 152.3?±?16.7?mmHg, obviously below the 250 to 300?mmHg previously recommended (J Bone Joint Surg Br 68:625-628, 1986 and Arthroscopy 11:307–311, 1995). Conclusions In conclusion, this adaptive method and apparatus which can provide minimal inflation pressure may be a clinically practical alternative for upper limb surgery performed with pneumatic tourniquets.
机译：背景技术气动止血带是一种医疗设备，可阻止血液流向四肢的远端，通常用于上肢手术中以提供干燥，清洁和无血的区域。为了减少因气压止血带的高充气压力导致的压力相关伤害和潜在的并发症风险，建议使用最小充气压力。方法基于数​​个体积描记器，通过对几种可能的影响参数与周围脉搏消失的最小气压止血带压力之间的相关性分析，建立新的上肢阻塞压力数学模型。针对上肢开发了一种自适应气压止血带的原型，该原型根据上述预测模型自动改变止血带袖带中的压力，该上肢使用了尽可能低的充气压力来实现闭塞。该原型包括血压监测模块，可充气的止血带袖带和压力释放机制，以维持最佳的袖带充气压力。进行了仿真实验，以验证所设计的自适应气压止血带的功能和稳定性，并使用志愿者进行了临床实验，以评估原型设计在实现上肢充分止血方面的性能。结果结果表明，平均动脉阻塞压力为152.3？±？16.7？mmHg，明显低于先前推荐的250至300？mmHg（J Bone Joint Surg Br 68：625-628，1986和Arthroscopy 11：307-311，1995 ）。结论总之，这种可提供最小充气压力的自适应方法和设备可能是用气动止血带进行上肢手术的临床实用替代方法。

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