[The tourniquet-syndrome--a severe complication after embolectomy of saddle embolism (author's transl)].

The symptoms of the tourniquet syndrome (hypotonia, tachycardia, postischemic edema, hypercaliemia, metabolic acidosis, myoglobinuria, renal insufficiency) could be observed after embolectomy of saddle embolism in 37 patients. 19 patients died postoperatively; heart insufficiency was demonstrated by autopsy in 14 patients. The pathophysiology of heart failure in tourniquet syndrome was studied in dog experiments after unilateral and bilateral hind limb ischemia. The development of shock turned out to be more severe after bilateral ischemia--comparable to saddle embolism--than after unilateral ischemia. The course of heart failure after recirculation could be referred to hypercaliemia, hypermagnesiemia, metabolic acidosis and hemoconcentration. The prophylaxis of the tourniquet syndrome can be practised by knowing the pathogenesis.