Near-infrared spectroscopy identifies compartment syndrome in an infant

Acute compartment syndrome is a surgical emergency requiring immediate intervention to limit tissue and nerve injury. Although the measurement of compartment pressure is frequently performed, there is controversy regarding the pressure at which fasciotomy should be performed. Near-infrared spectroscopy (NIRS) uses the same technology as pulse oximetry to estimate tissue oxygenation. To date, NIRS is used most commonly to estimate cerebral oxygenation during intraoperative anesthetic care. The authors present a 1-month-old infant who developed an acute compartment syndrome of the right lower extremity after cardiac surgery. In addition to the measurement of compartment pressures, the diagnosis of compartment syndrome was confirmed by NIRS with a value of 15% in the involved leg versus 40% to 50% in the noninvolved contralateral lower extremity. The potential use of this modality in identifying compartment syndrome is reviewed.