Continuous Intracompartmental Pressure Monitoring for Acute Compartment Syndrome

Duckworth, Andrew D.; McQueen, Margaret M.

doi:10.2106/jbjs.st.m.00023

Cited by 12 publications

(17 citation statements)

References 23 publications

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“…In our review, measurement of compartment pressures occurred in 12 (36.4%) cases. Although there are potentially numerous limitations to compartment pressure monitoring [57], many have shown ICP monitoring to be accurate, sensitive, and reliable with various available techniques [44,58]. In cases of diagnostic uncertainty or where the patient is unable to cooperate with the examination, ICP monitoring is important to avoid a delay in diagnosis [44,59].…”

Section: Discussionmentioning

confidence: 99%

Atraumatic Bilateral Acute Compartment Syndrome of the Lower Legs: A Review of the Literature

Warren¹,

Dhillon²,

Muscat³

et al. 2021

Cureus

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Bilateral acute compartment syndrome of the legs is a very rare presentation that requires emergency surgical intervention. Atraumatic bilateral cases are almost unheard of in medicine. There is currently no link between compartment syndrome and cognitive impairment or mental health.A systematic literature search was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines using the following keywords in multiple databases: compartment syndrome, atraumatic, spontaneous, bilateral, both, lower leg, acute, compartmental pressure, and fasciotomy. Atraumatic, bilateral, acute, and confirmed compartment syndrome cases were included.In total, 33 cases of atraumatic bilateral acute compartment syndrome (ABACS) were identified, of those 72.7% of cases were males. A form of cognitive impairment was found in 66% of cases. The medical history of the cases included substance abuse (nine patients), mental health illness (seven patients), and hypothyroidism (four patients). Within the reports, there was evidence of a misdiagnosis or delayed management in 19 cases (57.6%). Creatinine kinase (CK) was measured in 28 cases with a mean CK of 110,893 IU/L. Compartment pressure measurements were used in only 12 cases. A total of 29 cases were managed with bilateral four-compartment fasciotomy. This review highlights that ABACS is a condition with high rates of misdiagnosis or delay in treatment. Associations found included patients with cognitive impairment on presentation, mental health conditions, substance misuse, and elevated levels of CK. In addition, this review demonstrates that this condition is less rare than previously thought with serious morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Atraumatic Bilateral Acute Compartment Syndrome of the Lower Legs: A Review of the Literature

Warren¹,

Dhillon²,

Muscat³

et al. 2021

Cureus

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“…El diagnóstico de síndrome compartimental es primordialmente clínico y requiere el manejo inmediato con fasciotomía; sin embargo, el seguimiento postoperatorio puede apoyarse de la medición de la presión intracompartimental 40,56 . Se recomienda realizar la monitorización por al menos 24 h o hasta que se observe una disminución consistente de la presión y un incremento del diferencial de presión 57 . El dolor y la incomodidad local se presentan en un 25-40% de los pacientes, pero, al igual que otras complicaciones locales, suele resolverse en unas 2-3 semanas 32,58 .…”

Section: Complicaciones Postoperatoriasunclassified

Consideraciones perioperatorias en el paciente oncológico sometido a perfusión aislada de la extremidad

Cuéllar-Guzmán¹,

Ferretiz-López²,

Cárdenas-Herrera³

2022

GAMO

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Gaceta Mexicana de Oncologia. 2017;16(5):289-294 Resumen La perfusión aislada de la extremidad (PAE) y la perfusión hipertérmica aislada de la extremidad (PHAE) son procedimientos utilizados para el tratamiento de diversos tumores localizados en las extremidades (primordialmente melanoma y tumores de tejidos blandos), inducen una elevada tasa de respuesta tumoral y se asocian a una elevada tasa de salvamento de la extremidad, representando una alternativa a la amputación. Se trata de procedimientos complejos y con una elevada dificultad técnica que requieren del esfuerzo de todo un equipo multidisciplinario (cirujano, anestesiólogo, enfermera, perfusionista e intensivista). Los cambios hemodinámicos, la fuga de los fármacos a través de vasos colaterales, su toxicidad local y sistémica, así como las potenciales complicaciones, requieren de la monitorización continua e invasiva durante el procedimiento y de una estrecha vigilancia posquirúrgica. El propósito de este artículo de revisión fue analizar las pautas para el abordaje perioperatorio del paciente oncológico que se somete a este procedimiento. (creativecommons.org/licenses/by-nc-nd/4.0/). abstract Isolated limb perfusion (ILP) and hyperthermic ILP (HILP) are therapeutic options for patients with unresectable malignancies in the extremities (e.g. primarily melanoma and soft tissue tumors), they induce a high rate of tumor response; associates with high limb salvage rates and represents an effective alternative to amputation. These are challenging procedures with a high technical difficulty that require the efforts of a multidisciplinary team (surgeon, anesthesiologist, nurse, perfusionist and intensivist). Hemodynamic changes, drug leakage through collateral vessels, local and systemic toxicity, and potential complications require continuous and invasive monitoring during the procedure and rigorous post-surgical monitoring. The purpose of this review article was to update the strategies for the perioperative care of cancer patients undergoing this procedure.

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“…The diagnosis of compartmental syndrome is essentially clinical, and it requires immediate management with fasciotomy; however, postoperative follow-up can be supported by intra-compartmental pressure monitoring 40,56 . Monitoring for at least 24 h is recommended or until a consistent pressure decrease and pressure differential increase is observed 57 .…”

Section: Postoperative Complicationsmentioning

confidence: 99%

Perioperative considerations in the oncologic patient undergoing isolated limb perfusion

Cuéllar-Guzmán¹,

Ferretiz-López²,

Cárdenas-Herrera³

2022

GAMO

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Isolated limb perfusion (ILP) and hyperthermic ILP (HILP) are therapeutic options for patients with unresectable malignancies in the extremities (e.g., primarily melanoma and soft tissue tumors), they induce a high rate of tumor response; associates with high limb salvage rates and represents an effective alternative to amputation. These are challenging procedures with a high technical difficulty that require the efforts of a multidisciplinary team (surgeon, anesthesiologist, nurse, perfusionist and intensivist). Hemodynamic changes, drug leakage through collateral vessels, local and systemic toxicity, and potential complications require continuous and invasive monitoring during the procedure and rigorous post-surgical monitoring. The purpose of this review article was to update the strategies for the perioperative care of cancer patients undergoing this procedure.

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Continuous Intracompartmental Pressure Monitoring for Acute Compartment Syndrome

Cited by 12 publications

References 23 publications

Atraumatic Bilateral Acute Compartment Syndrome of the Lower Legs: A Review of the Literature

Atraumatic Bilateral Acute Compartment Syndrome of the Lower Legs: A Review of the Literature

Consideraciones perioperatorias en el paciente oncológico sometido a perfusión aislada de la extremidad

Perioperative considerations in the oncologic patient undergoing isolated limb perfusion

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