Comparison of 2 available methods with Bland-Altman analysis for measuring intracompartmental pressure

Tian, Shengjie; Lu, Yaogang; Ju, Liu; Zhu, Ying; Chen, Yin; Lu, Jiayun

doi:10.1016/j.ajem.2016.06.010

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…Forty-one studies were included in the final review (Tables 1-4). [1–41] A total of 865 animals were included with an average of 22.2 animals per study. Dogs (31.7%) were the most used model species, followed by pigs (26.8%) and rats (24.4%).…”

Section: Resultsmentioning

confidence: 99%

Animal models in compartment syndrome: a review of existing literature

O’Neill¹,

Boes²,

McCutcheon³

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objective: Extremity compartment syndrome (ECS) is a morbid condition resulting in permanent myoneural damage. Currently, the diagnosis of compartment syndrome relies on clinical symptoms and/or intracompartment pressure measurements, both of which are poor predictors of ECS. Animal models have been used to better define cellular mechanisms, diagnosis, and treatment of ECS. However, no standardized model exists. The purpose of this study was to identify existing animal research on extremity compartment syndrome to summarize the current state of the literature and to identify weaknesses that could be improved with additional research. Methods: A MEDLINE database search and reverse inclusion protocol were utilized. We included all animal models of ECS. Results: Forty-one studies were included. Dogs were the most commonly used model species, followed by pigs and rats. Most studies sought to better define the pathophysiology of compartment syndrome. Other studies evaluated experimental diagnostic modalities or potential treatments. The most common compartment syndrome model was intracompartment infusion, followed by tourniquet and intracompartment balloon models. Few models incorporated additional soft tissue or osseous injury. Only 65.9% of the reviewed studies confirmed that their model created myoneural injury similar to extremity compartment syndrome. Conclusions: Study purpose, methodology, and outcome measures varied widely across included studies. A standardized definition for animal compartment syndrome would direct more consistent research in this field. Few animal models have investigated the pathophysiologic relationship between traumatic injury and the development of compartment syndrome. A validated, clinically relevant animal model of extremity compartment syndrome would spur improvement in diagnosis and therapeutic interventions.

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Section: Resultsmentioning

confidence: 99%

Animal models in compartment syndrome: a review of existing literature

O’Neill¹,

Boes²,

McCutcheon³

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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“…The final articles included 33 clinical studies and 1 with both human participants and rabbit subjects (Table 1). Furthermore, 15 animal models and 2 cadaveric studies were included in this review (Table 2). This study includes 852 human participants and 319 animals, out of which there were 27 dogs (specifically beagles), 53 pigs, 118 rabbits, and 121 rats.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Modalities for Acute Compartment Syndrome of the Extremities

et al. 2019

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IMPORTANCE Acute compartment syndrome (ACS) can cause catastrophic tissue damage leading to permanent muscle and nerve loss. Acute compartment syndrome is a clinical diagnosis, with intracompartmental pressure (ICP) used in equivocal cases. There are no reliable diagnostic methods. The clinical evaluation is impossible to standardize, and the threshold for ICP has been known to be unreliable; thus, guidelines for diagnosis can result in overtreatment or delayed diagnosis.OBJECTIVE To present and review the advantages and disadvantages of each diagnostic modality and identify gaps that need to be addressed in the future and to review the most used and appropriate animal and human ACS models. EVIDENCE REVIEWWe included clinical studies and animal models investigating diagnostic modalities for ACS of the extremities. A MEDLINE and Web of Science search was performed. The protocol for the study was registered on PROSPERO (CRD42017079266). We assessed the quality of the clinical studies with Newcastle-Ottawa scale and reported level of evidence for each article.FINDINGS Fifty-one articles were included in this study, reporting on 38 noninvasive and 35 invasive modalities. Near-infrared spectroscopy and direct ICP measurement using a Stryker device were the most common, respectively. Cadaveric studies used saline infusions to create an ACS model. Most studies with human participants included injured patients with acquired ACS or at risk of developing ACS. In healthy human participants, tourniquets formed the most commonly used ACS model. Application of tourniquets and infusion of saline or albumin were the most used ACS models among animal studies. CONCLUSIONS AND RELEVANCEThis article reports on the most common as well as many new and modified diagnostic modalities, which can serve as inspiration for future investigations to develop more effective and efficient diagnostic techniques for ACS. Future studies on diagnostic modalities should include the development of tools for continuous assessment of ICP to better identify the earliest alterations suggestive of impending ACS. With the advent of such technologies, it may be possible to develop far less aggressive and more effective approaches for early detection of ACS.

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“…A variety of pressure monitoring equipment is available, including traditional needle manometry (Whiteside’s’ technique) [34], transducer and multi-parameter monitors usually used to monitor arterial blood pressure [37] and dedicated compartment pressure monitors (e.g. transducer tipped intracompartmental pressure monitors).…”

Section: Introductionmentioning

confidence: 99%

Diagnosing acute compartment syndrome—where have we got to?

McMillan

Gardner

Schmidt

et al. 2019

International Orthopaedics (SICOT)

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PurposeAcute compartment syndrome is a condition whereby tissue ischaemia occurs due to increased pressure in a closed myofascial compartment. It is a surgical emergency, with rapid recognition and treatment—the keys to good outcomes.MethodsThe available literature on diagnostic aids was reviewed by one of the senior authors 15 years ago. Now, we have further reviewed the literature, to aim to ascertain what progress has been made.ResultsIn this review, we present the evidence around a variety of available diagnostic options when investigating a potential case of acute compartment syndrome, including those looking at pressure changes, localised oxygenation, perfusion, metabolic changes and available blood serum biomarkers.ConclusionsA significant amount of work has been put into developing modalities of diagnosis for acute compartment syndrome in the last 15 years. There is a lot of promising outcomes being reported; however, there is yet to be any conclusive evidence to suggest that they should be used over intracompartmental pressure measurement, which remains the gold standard. However, clinicians should be cognizant that compartment pressure monitoring lacks diagnostic specificity, and could lead to unnecessary fasciotomy when used as the sole criterion for diagnosis. Therefore, pressure monitoring is ideally used in situations where clinical suspicion is raised.

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Comparison of 2 available methods with Bland-Altman analysis for measuring intracompartmental pressure

Cited by 7 publications

References 23 publications

Animal models in compartment syndrome: a review of existing literature

Animal models in compartment syndrome: a review of existing literature

Diagnostic Modalities for Acute Compartment Syndrome of the Extremities

Diagnosing acute compartment syndrome—where have we got to?

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