Effect of prolonged venostasis on lipid profile parameters among apparently healthy University students: A case-control study in Ghana

Richard K.D Ephraim

doi:10.51374/annalsmls.2021.1.1.0016

Abstract

Background: The effect of prolonged tourniquet application on lipid profile parameters (total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c)) among healthy students in the University of Cape Coast was assessed in this study. Methods: A total of 30 participants were sampled and venous blood was taken from both arms at different duration of tourniquet application. Blood was allowed to clot, centrifuged and serum separated and stored until assay. Lipid profile parameters were measured using the enzymatic techniques with the aid of a spectrophotometer. Lipid parameters were expressed in mmol/L. The relationship between the concentrations was analyzed using GraphPad Prism version 6.0. Results: The mean serum levels of total cholesterol and HDL-c were significantly (p<0.05) elevated after long duration (13.44±2.40 s) of tourniquet application compared to short duration (11.20±0.38 s) of tourniquet application. Despite the fact that the serum levels of triglyceride and LDL-c increased after long duration of tourniquet application compared to short duration, the difference was not significant (p>0.05). There was significant % mean differences of 7.0% (p<0.0001) and 11.2% (p=0.0082) in the concentrations of total cholesterol and HDL-c respectively following prolonged tourniquet application of 120-180 s. A significant increase of up to 7% (5.01±0.04, 5.352±0.05, p<0.0001) and 11% (2.41±0.07, 2.674±0.07, p=0.0082) in the concentrations of total cholesterol and HDL-c respectively was also recorded. Conclusion: Prolonged venostasis has a direct effect on the concentration of serum total cholesterol and HDL-c but not triglyceride and LDL-c. Nonapplication of tourniquet in patients with prominent veins, the application of standardized external pressure as well the early release of tourniquet after needle insertion in the vein should be followed during sample taking for lipid profile. Annals of Medical Laboratory Science (2021) 1(1), 1 - 7

Highlights

In most clinical and laboratory set-up, phlebotomists apply tourniquet during venipuncture
Long duration of tourniquet application compared to short duration, the difference was not significant (p>0.05)
Prolonged venostasis has a direct effect on the concentration of serum total cholesterol and HDL-c but not triglyceride and LDL-c

Summary

Introduction

In most clinical and laboratory set-up, phlebotomists apply tourniquet during venipuncture This is mostly seen when taking blood samples of infants, the obese, immunosuppressed or the geriatrics whose veins are difficult to locate. Lippi et al, (2005) commented on the significant alterations in alanine transaminase (ALT), total calcium, sodium, urea, total glycerol, albumin, bilirubin, potassium, glucose, iron and creatine kinase after applying a sphygmomanometer at the same pressure. This alteration can be traced to the prolonged venostasis and neither pressure on the vascular endothelium nor hypoxia as suggested by Young et al, (2006)

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