Near-infrared spectroscopy: A potential method for continuous, transcutaneous monitoring for compartmental syndrome in critically injured patients

Saman Arbabi, Susan I. Brundage, Larry M. Gentilello

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

Background: Near-infrared spectroscopy (NIRS) noninvasively measures tissue O2 saturation (Sto2), and has been proposed as a means of monitoring for compartmental syndrome (CS). However, its specificity in hypoxemic, hypotensive patients with severely reduced systemic oxygen delivery has not been tested. We hypothesized that NIRS can differentiate muscle ischemia caused by shock from ischemia caused by CS. Methods: Nine swine were anesthetized and an NIRS probe placed over the anterolateral compartment of the hind leg. Compartment pressure was also measured. A nerve stimulator was placed over the peroneal nerve, and CS was defined as loss of dorsiflexion twitch. At 30-minute sequential intervals, mean arterial blood pressure was reduced to 60% of baseline (phlebotomy), fraction of inspired oxygen was reduced to 0.15, and compartment pressure was increased in one limb by interstitial albumin infusion until CS occurred Results: Hypotension combined with hypoxemia reduced Sto2 from 82 ± 4% to 66 ± 10%. CS further reduced Sto2 to 16 ± 12% (p < 0.0001). During hypotension + hypoxemia + CS, control limb Sto2 was 70 ± 15% (p = 0.0002 vs. experimental limb). Conclusion: NIRS detects muscle ischemia caused by CS despite severe hypotension and hypoxemia, making it potentially useful in critically injured, unstable patients.

Original languageEnglish (US)
Pages (from-to)829-823
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume47
Issue number5
DOIs
StatePublished - Nov 1999

Keywords

  • Compartment syndromes
  • Critical care
  • Fractures
  • Ischemia
  • Musculoskeletal physiology
  • Orthopedic equipment
  • Orthopedics
  • Reperfusion injury
  • Shock
  • Spectroscopy near infrared
  • Traumatology

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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