The 50 original articles included in this qualitative , systematic review revealed that the recommendations " Tourniquet " of the DGAI published in 2016 are mostly still up to date despite an inhomogeneous study situation .
INTRODUCTION The effectiveness of a  tourniquet  in the case of life-threatening hemorrhages of the extremities is well recognized and led to the recommendations on " Tourniquet " of the German Society of Anaesthesiology and Intensive Care ( DGAI ) in 2016 .
The aim of this systematic review was to re-evaluate the current medical literature in relation to the published DGAI recommendations .
Impact of Phlebotomy Tourniquet Use on Blood Lactate Levels in Acutely Ill Patients.
OBJECTIVE Lactate levels are increasingly used to guide resuscitation efforts . Some surgical literature suggests that tourniquet use during phlebotomy falsely elevates results , although studies in healthy volunteers have not demonstrated this . The purpose of this study was to determine in clinical practice whether tourniquet use during the drawing of a lactate results in significantly altered levels compared to the result of a level drawn without a tourniquet . METHODS A prospect i ve cohort study was carried out on emergency department patients whose clinical presentation led a physician to order a lactate level . Written informed consent was obtained from patients or their proxies . Study  lactates  were obtained using a tourniquet during the draw sequence of other laboratory studies . Lactate levels for clinical use were drawn per hospital protocol with no tourniquet . The time of lactate measurements and patient demographic information were recorded . Lactate levels for each patient were compared with the Wilcoxon Rank-Sum Test . RESULTS 40 patients were consented and enrolled . The median clinical lactate level was 1.9 ( interquartile range 1.5 - 2.6 ) , and the median study lactate level was 1.9 ( interquartile range 1.4 - 2.7 ) . There was no difference between paired lactate values ( p=0.95 ) . CONCLUSIONS Tourniquet use appears to have no impact on measured lactate levels . Our findings suggest that current practice s at many institutions regarding lactate collection are likely too stringent and should be changed
The 50 original articles included in this qualitative , systematic review revealed that the recommendations " Tourniquet " of the DGAI published in 2016 are mostly still up to date despite an inhomogeneous study situation .
INTRODUCTION The effectiveness of a  tourniquet  in the case of life-threatening hemorrhages of the extremities is well recognized and led to the recommendations on " Tourniquet " of the German Society of Anaesthesiology and Intensive Care ( DGAI ) in 2016 .
The aim of this systematic review was to re-evaluate the current medical literature in relation to the published DGAI recommendations .