Acute Compartment Syndrome

Posted by e-Medical PPT
An increased pressure within enclosed osteofascial space that reduces capillary per-fusion below level necessary for tissue
viability; the underlying mechanism is:
- increased volume within space
- decreased space for contents
- combination of both

Etiology
Trauma with bleeding/swelling
Bleeding disorders
Burns
Tight wraps
Traction
Surgical positioning
Pneumatic antishock garment
Reprefusion swelling

Pathophysiology:
Increased compartment pressure leads to increased venous pressure which decreases A-V gradient resulting in muscle and nerve ischemia.

Variables to Consider
Vascular tone
Blood pressure
Duration of elevated pressure
Metabolic demand of tissue
Lowered ischemic threshold of damaged muscle

Myoglobinemia
Released in high levels at reperfusion
Toxic to glomeruli
Metabolic acidosis & hperkalemia
Together lead to:Renal failure,Cardiac arrhythmia & failure,Hypothermia and Shock

Diagnosis
Clinical exam: the Ps(Pressure,Pain,Paresthesia,Paralysis,Pallor,Pulselessness)
Compartment pressures
Laboratory tests-CPK and Urine myoglobin

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