Pathology and diagnostic options of lower limb compartment syndrome

E. Arató, M. Kürthy, L. Sínay, G. Kasza, G. Menyhei, S. Masoud, A. Bertalan, Zs Verzár, L. Kollár, E. Rőth, G. Jancsó

Research output: Contribution to journalArticle

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Abstract

Background: The indication of surgical treatment in lower limb compartment syndrome mostly depends on the clinical signs which can be often uncertain, resulting in delayed insufficient intervention. Aim: The aim of the study was to evaluate the progression of compartment syndrome by measuring of intracompartmental pressure and monitoring of decreased tissular oxygenation, indicating an insufficient secondary microcirculation. Materials and methods: 16 patients were examined in our study (12 males, 4 females, mean age: 62.7±9.5 years), who underwent acute lower limb revascularization surgery for a critical (lasting more than 4 hours) limb ischemia. The indications were: 5 iliac artery embolizations and 11 femoral artery occlusions. After revascularization, on the second postoperative day, we detected significant lower limb edema and swelling of several grade. To monitor the elevated intracompartmental pressure (ICP) and to evaluate the extremital circulation, we used KODIAG pressure meter and the tissular oxygen saturation (StO2) was measured by near-infrared-spectroscopy. Results: In 12 cases the ICP exceeded the critical 40 mmHg. In these patients the average StO2 was 50-53%, in spite of complete recanalization. In these cases we made urgent, semi-open fasciotomy. In 4 cases, where the clinical aspect showed compartment syndrome, the measured parameters did not indicate a surgical intervention (ICP: 25-35 mmHg, StO2: around normal). Summary: A novel approach in our examination is that, besides empirical therapeutic guidelines generally applied in clinical practice, we established an objective, parameter-based ("evidence based medicine") surgical indication strategy for the lower limb compartment syndrome. Our parameter results produced by the above pressure and saturation measurements help the clinicians to decide between conservative and operative treatment of the disease.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalClinical Hemorheology and Microcirculation
Volume41
Issue number1
DOIs
Publication statusPublished - 2009

Fingerprint

Compartment Syndromes
Lower Extremity
Pathology
Pressure
Near-Infrared Spectroscopy
Iliac Artery
Evidence-Based Medicine
Femoral Artery
Microcirculation
Edema
Ischemia
Extremities
Guidelines
Oxygen
Therapeutics

Keywords

  • Compartment syndrome
  • Fasciotomy
  • Intracompartmental pressure measurement
  • Oxidative stress
  • Tissular oxygen saturation

ASJC Scopus subject areas

  • Hematology
  • Physiology
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Arató, E., Kürthy, M., Sínay, L., Kasza, G., Menyhei, G., Masoud, S., ... Jancsó, G. (2009). Pathology and diagnostic options of lower limb compartment syndrome. Clinical Hemorheology and Microcirculation, 41(1), 1-8. https://doi.org/10.3233/CH-2009-1145

Pathology and diagnostic options of lower limb compartment syndrome. / Arató, E.; Kürthy, M.; Sínay, L.; Kasza, G.; Menyhei, G.; Masoud, S.; Bertalan, A.; Verzár, Zs; Kollár, L.; Rőth, E.; Jancsó, G.

In: Clinical Hemorheology and Microcirculation, Vol. 41, No. 1, 2009, p. 1-8.

Research output: Contribution to journalArticle

Arató, E, Kürthy, M, Sínay, L, Kasza, G, Menyhei, G, Masoud, S, Bertalan, A, Verzár, Z, Kollár, L, Rőth, E & Jancsó, G 2009, 'Pathology and diagnostic options of lower limb compartment syndrome', Clinical Hemorheology and Microcirculation, vol. 41, no. 1, pp. 1-8. https://doi.org/10.3233/CH-2009-1145
Arató, E. ; Kürthy, M. ; Sínay, L. ; Kasza, G. ; Menyhei, G. ; Masoud, S. ; Bertalan, A. ; Verzár, Zs ; Kollár, L. ; Rőth, E. ; Jancsó, G. / Pathology and diagnostic options of lower limb compartment syndrome. In: Clinical Hemorheology and Microcirculation. 2009 ; Vol. 41, No. 1. pp. 1-8.
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