Acute Compartment Syndrome as a Complication of Radial Artery Catheterization

Gergoudis, Maria; Raizman, Noah

doi:10.1016/j.jhsg.2022.03.002

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…Elevated body temperature can also result from severe stress responses in fracture patients, who are at high risk of developing ACS. Previous reported cases of intraoperative ACS mainly focused on the symptoms and treatment of local pathological tissues, with little attention to temperature changes [10][11][12] .…”

Section: Discussion Andmentioning

confidence: 99%

“…Acute compartment syndrome (ACS) occurs as a result of increased pressure within the relatively inelastic osteofascial compartments, which can lead to compromised perfusion and ischemic tissue damage. Intraoperative ACS related to anesthesia has been previously reported, including extravasation of peripheral intravenous blood transfusion or chemicals [10] , improper prone position [11] , pressurized intravenous uids, and radial artery cannulation [12] . In conscious patients, disproportionate pain and passive traction pain are the initial and most sensitive symptoms of ACS, while elevated body temperature is considered to be a concomitant symptom.…”

Section: Discussion Andmentioning

confidence: 99%

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Intraoperative hyperthermia related to acute compartment syndrome under general anesthesia：a case report

Zhao

2023

Preprint

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Background: Intraoperative hyperthermia is a potentially life-threatening condition that requires prompt recognition and management. In this article, we will present a case of intraoperative hyperthermia resulting from acute compartment syndrome. Case presentation: A young patient developed hyperthermia during general anesthesia. He also showed hemodynamic fluctuations, metabolic acidosis. Physical examination revealed absent pulsation in the left dorsal artery and tensely swollen, cyanotic skin on the lower leg. The patient received immediate swelling relief and cooling measresures which resulted in a gradual reduction of his body temperature, improvement in metabolic acidosis and hemodynamic stability. After the surgical procedure, the patient was transferred to the intensive care unit for further monitoring and extubation was performed the next day. Conclusions: Anesthesiologists should be aware of the possibility of acute compartment syndrome in patients with unexplained temperature rise after the exclusion of other causes.

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Section: Discussion Andmentioning

confidence: 99%

Section: Discussion Andmentioning

confidence: 99%

Intraoperative hyperthermia related to acute compartment syndrome under general anesthesia：a case report

Zhao

2023

Preprint

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“…7 Acute compartment syndrome is diagnosed clinically based on the prompt recognition of those symptoms, and in cases where the diagnosis is ambiguous, the measurement of compartment pressures may be used to confirm the diagnosis. 8 The cardinal sign and symptoms of AS involving "5P": pain, paresthesia, pallor, pulselessness, and paralysis. The most frequent and identifying symptom is severe pain.…”

Section: Discussionmentioning

confidence: 99%

Acute compartment syndrome of the forearm after trans-radial approach to percutaneous coronary intervention: a case report

Irsan,

Persada Isma,

Alifian

et al. 2023

JMedScie

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Percutaneous coronary intervention (PCI) through transradial pathway is associated with lower risk of severe vascular problems comparing to transfemoral. It is reported that the acute compartment syndrome (ACS) in forearm is significant lower comparing to leg. A 47 y.o. male with ACS following a transradial approach of PCI due to inferior myocardial infarction was reported. The patient experienced pain and swelling in his right forearm for 7 hr after the procedure and was later brought to hospital and treated with emergency of fasciotomy. The patient showed good post-fasciotomy recovery on the first 2 wk and showed good DASH score after 4 wk. Quick diagnosis with prompt treatment makes a better outcome for the patient. Consequently, a high level of awareness to make the diagnosis as quickly and accurately management as possible could prevent morbidity caused by late and unrecognized management compartment syndrome eventually could make a better clinical outcome.

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“…2 Acute compartment syndrome is characterized by an increase in pressure within a fascial compartment and results in a decrease in venous outflow, and eventually, arterial inflow may be prevented, leading to ischemia and necrosis. 3 The transradial approach to cardiac catheterization is commonly referred to as the transfemoral approach due to lower risks of access site bleeding and major vascular complications. 1,3 Treatment for acute compartment syndrome is emergent fasciotomy of the affected compartments to reduce intracompartmental pressure.…”

Section: Introductionmentioning

confidence: 99%

“…3 The transradial approach to cardiac catheterization is commonly referred to as the transfemoral approach due to lower risks of access site bleeding and major vascular complications. 1,3 Treatment for acute compartment syndrome is emergent fasciotomy of the affected compartments to reduce intracompartmental pressure. 1 Up to 15-23% of the patients with (PCI) implantation need a surgical procedure <12 months from PCI.…”

Section: Introductionmentioning

confidence: 99%

Axillary Plexus Block for Anesthesia Management in Patients with Acute Compartment Syndrome after Primary Percutaneous Coronary Intervention (PCI) Transradial Approach: A Case Report

Renaldi,

I Made Gede Widnyana,

Otniel Adrians Labobar

2023

Bioscmed

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Background: Acute compartment syndrome is a rare complication of the percutaneous Coronary Intervention (PCI) transradial approach but it is very hand-threatening. Treatment for acute compartment syndrome is emergent fasciotomy of the affected compartments to reduce intracompartmental pressure. Axillary plexus block is an excellent choice of anesthesia technique for elbow, forearm, and hand surgery. Case presentation: An 80-year-old, 60 kg, 168 cm man was consulted to our department with a painful swelling on his right upper arm and hand that began three hours after a primary PCI procedure. Previously, the patient had a history of hypertension and diabetes mellitus. The supporting examination results were notable for anemia (Hemoglobin 7,5 g/dL), thrombocytopenia (78 x103/uL), elevated hemostasis function (International Normalized Ratio 1.43), and high blood sugar (360 mg/dL) from echocardiography results anteroseptal and lateral hypokinetic. Before we did block, the patient was given ketamine 10 mcg IV and fentanyl 25 mcg IV for sedation. Axillary plexus block, as a type of regional anesthesia under ultrasound guidance, is a reliable substitute for general anesthesia in high-risk patients, and we do it with a dose of 20 ml of solution (50 mg (10 ml) isobaric bupivacaine 0.5% + 200 mg lidocaine 2% diluted with 20 ml normal saline). During the surgery, the patient was hemodynamically stable. After the operation, the patient was readmitted to the intensive cardiac care unit (ICCU). Conclusion: Axillary plexus block can be an alternative to general anesthesia in patients who will undergo fasciotomy surgery after percutaneous coronary intervention transradial approach with stable hemodynamics during surgery and well-controlled pain after the surgery.

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Acute Compartment Syndrome as a Complication of Radial Artery Catheterization

Cited by 6 publications

References 6 publications

Intraoperative hyperthermia related to acute compartment syndrome under general anesthesia：a case report

Intraoperative hyperthermia related to acute compartment syndrome under general anesthesia：a case report

Acute compartment syndrome of the forearm after trans-radial approach to percutaneous coronary intervention: a case report

Axillary Plexus Block for Anesthesia Management in Patients with Acute Compartment Syndrome after Primary Percutaneous Coronary Intervention (PCI) Transradial Approach: A Case Report

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