The Effects of Limb Elevation and Dependency on Local Arteriovenous Gradients in Normal Human Limbs with Particular Reference to Limbs with Increased Tissue Pressure

Matsen, Frederick A.; Wyss, C R; Krugmire, Richard B.; Simmons, Charles W.; King, Racheal V.

doi:10.1097/00003086-198007000-00031

Cited by 58 publications

(25 citation statements)

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“…The infusion pressure in arthroscopy may exceed that demonstrated to cause tissue ischemia in compartmental syndromes. 27,28 Third, chondrolysis can be observed with the postoperative infusion of a solution that does not have the same temperature, oxygenation, pH, viscosity, and nutrient composition as normal joint fluid.…”

Section: Factors Reported In Cases Of Chondrolysismentioning

confidence: 99%

Glenohumeral chondrolysis: A systematic review of 100 cases from the English language literature

Scheffel

Clinton

Lynch

et al. 2010

Journal of Shoulder and Elbow Surgery

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Section: Factors Reported In Cases Of Chondrolysismentioning

confidence: 99%

Glenohumeral chondrolysis: A systematic review of 100 cases from the English language literature

Scheffel

Clinton

Lynch

et al. 2010

Journal of Shoulder and Elbow Surgery

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“…Local tissue perfusion is dependent upon the arteriovenous pressure gradient. Matsen et al (9), in three normal subjects, examined the effect of lower extremity elevation on the arteriovenous pressure gradient, first with no pressure and then with 60 mm Hg pressure applied to the limb. They found that elevating the foot lowered the local arterial pressure by an amount equal to the hydrostatic column pressure; thus, for each centimeter the foot was elevated above heart level, the local arterial pressure decreased by 0.8 mm Hg (1.0 cm whole blood divided by 1.3 cm whole blood/mm Hg).…”

Section: Discussionmentioning

confidence: 99%

Effects of elevation on nerve function in an acute upper extremity nerve compression model

Chidgey

Szabo

Kolack

1989

Journal Orthopaedic Research

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External compression was applied to the palmar surface of the wrist over the carpal tunnel in eight healthy volunteer subjects. With the arm in the maximum elevated position, the carpal tunnel pressure was elevated to 50 mm Hg, being continuously monitored by a slit catheter inserted into the carpal canal. Sensory and motor latencies and amplitudes were evaluated at 1-min intervals. When the sensory amplitude decreased by 50% (correlating with subjective sensory changes), the hand was lowered to heart level, still maintaining the carpal tunnel pressure at 50 mm Hg. Nerve conduction velocity and amplitude monitoring continued at 30-s intervals until complete sensory block. Four subjects demonstrated a transient reversal in the sensory amplitude decline with lowering of the hand to heart level, but soon progressed to a complete sensory block. The remaining four subjects demonstrated no change in the sensory amplitude decline with lowering of the hand to heart level. Our results suggest that with moderately elevated carpal tunnel pressures, once the sensory amplitude drops by 50% and the patient starts experiencing subjective sensory changes, lowering the hand to heart level may not change the local tissue blood flow sufficiently to maintain a sustained reversal in the declining nerve function and impending nerve damage.

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“…The limb should be kept at the level of the heart and not be elevated in the interim (or if the diagnosis is in doubt), as this decreases arterial flow and narrows the arterial-venous pressure gradient. 20 …”

Section: 1mentioning

confidence: 99%

Compartment syndrome in patients with haemophilia

Donaldson

Goddard

2015

Journal of Orthopaedics

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The Effects of Limb Elevation and Dependency on Local Arteriovenous Gradients in Normal Human Limbs with Particular Reference to Limbs with Increased Tissue Pressure

Cited by 58 publications

References 0 publications

Glenohumeral chondrolysis: A systematic review of 100 cases from the English language literature

Glenohumeral chondrolysis: A systematic review of 100 cases from the English language literature

Effects of elevation on nerve function in an acute upper extremity nerve compression model

Compartment syndrome in patients with haemophilia

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