Cause of death in tourniquet shock in rats

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Abstract
Application of bilateral tourniquets for 4 hr at 28 C is followed by accumulation of fluid, corresponding to 5% of body weight, into the hindlegs and a fall in mean blood pressure to 60-75 mm Hg. The circulatory changes are not severe enough to explain the 100% mortality found under these conditions. Just before death a sudden, secondary fall in blood pressure is found, accompanied by heart arrhythmia and severe ECG changes, indicative of K intoxication. Plasma K, which rises steadily after tourniquet removal, reaches a value of 10-13 mEq/1 just before death. Plasma Na is somewhat decreased. These electrolyte changes are caused by a loss of K from and an uptake of Na into the injured hindleg muscles. Animals can be saved a few minutes before death by intravenous injection of a few milliliters of 0.9% NaCl, followed by a massive intraperitoneal saline injection. K-deficient rats treated with the same tourniquet procedure show a 39% 24-hr survival, whereas the accumulation of fluid is identical to and the fall in blood pressure somewhat greater than in nonde-ficient rats. It is concluded that K intoxication is the principal cause of death in tourniquet shock.

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