Time course of muscle metabolic changes during tourniquet ischemia in man.

Muscle biopsies form the vastus lateralis muscle of the thigh were obtained from 11 patients before and at 15-min intervals following tourniquet application and 15 min after tourniquet release. The total circulatory occlusion time varied from 60 to 120 min. The concentrations of lactate, creatine phosphate and adenosine triphosphate were determined, and the muscle temperature was recorded. During the ischemic period, the lactate concentration increased from 1.9 mmol x kg-1 wet wt to 14.9 mmol x kg-1 wet wt after 90 min of ischemia. During the last 30 min of ischemia, no further increase in lactate concentration was observed. The creatine phosphate concentration decreased from 20.4 to 5.2 mmol x kg-1 wt wt after 120 min of ischemia. The temperature fell rapidly during the first 15 min from 35.9 degrees to 33.5 degrees and was then constant until 95 min when a further small decrease was observed. The adenosine triphosphate concentration did not change significantly during the ischemic period.