Diagnosis and management of compartmental syndromes.

N-acetylcysteine Protects Striated Muscle in a Model of Compartment Syndrome

“…1). We believe this replicates more closely the physiologic conditions encountered in early CS than tourniquet models [16,25,31].…”

“…Acute compartment syndrome (CS) is a condition in which the circulation and function of tissues in an enclosed space are compromised by increased pressure in that space [31]. In clinical practice, fasciotomy remains the only proven treatment of CS [31,47].…”

“…In clinical practice, fasciotomy remains the only proven treatment of CS [31,47]. Promptly establishing the diagnosis of CS and timing appropriate surgery remain important clinical challenges [31,34,47]; however, fasciotomy is not an entirely benign procedure and is associated with substantial morbidity locally and systemically and with potential mortality [34,47].…”

Compartment syndrome as a complication of the prolonged use of the Lloyd‐Davies position

“…The precise pressure/time threshold for irreversible nerve or muscle injury has not been determined and therefore criteria for surgical decompression remain controversial. Laboratory and clinical data suggest that significant long term sequelae d o not occur unless compartmental pressure is greater than 45 mmHg [5] or is elevated to within 10 to 30 mmHg of the diastolic pressure [6] or to within 30 to 40mmHg of the mean arterial blood pressure [7].…”

“…In a review of the surgical management of compartment syndromes, the quality of the functional result was directly related to the promptness with which decompression was performed. The frequency and severity of complications were inversely related to the promptness of decompression [5]. The most important factor in making the diagnosis is an adequate clinical index of suspicion, although increased awareness should reduce the sequelae, but not necessarily the incidence.…”