Acute Compartment Syndrome of the Forearm following Autologous Blood Reinfusion: A Case Report

Abstract

Compartment syndrome is a condition with multiple reported etiologies, and permanent disability may ensue if not treated in a timely fashion. We report the first case, to our knowledge, of acute forearm compartment syndrome caused by intravenous autologous blood reinfusion. The patient underwent forearm fasciotomy, and hematoma was encountered deep to the superficial volar fascia, presumably extravasated from the reinfusion catheter. With the rise in the number of knee and hip arthroplasties, surgeons need a heightened awareness of the possible complications and morbidity associated with a presumed increase in autologous blood reinfusion.

Intraoperative acute compartment syndrome of the upper limb secondary to extravasation

“…Intravenous access at the dorsum of the hand or near joints are sites most often implicated with extravasation injuries, possibly due to lesser soft tissue available to protect underlying structures 16. Other risk factors include compromised lymphatic or venous drainage, peripheral vascular disease, hypertension and radiation therapy 16 18 19. In our case, the patient was more than 50 years old and had prior chemotherapy, increasing the likelihood of having particularly fragile veins.…”

Acute Compartment Syndrome of the forearm in a patient undergoing coronary artery bypass surgery

“…Acute forearm compartment syndrome due to intravenous fluid extravasation is uncommon, but many case reports of forearm compartment syndrome due to mannitol extravasation[ 3 4 ] and autologous blood transfusion[ 5 ] have been published. This case report highlights the fact that although obtaining a secure intravascular access, securing it properly and constant visual inspection of the cannula site[ 3 6 ] are of paramount importance; this is not always possible particularly in surgeries where the upper limbs are tucked by the patient's side as a part of surgical positioning.…”