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[Compartment syndrome. Definition, etiology, pathophysiology].

H J Oestern1

  • 1Unfallchirurgische Klinik, Allgemeines Krankenhaus Celle.

Der Unfallchirurg
|May 1, 1991
PubMed
Summary

Compartment syndrome occurs when high pressure in a confined space restricts blood flow, potentially damaging tissue. Nerve and muscle tolerance to this pressure depends on the arterial pressure gradient, not just absolute pressure.

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Area of Science:

  • Orthopedics
  • Trauma Surgery
  • Vascular Surgery

Context:

  • Compartment syndrome is a surgical emergency characterized by elevated intracompartmental pressure.
  • Etiologies include increased compartment volume (hematoma, edema) or decreased volume (casts, dressings).
  • Understanding the pathophysiology is crucial for timely diagnosis and intervention.

Purpose:

  • To elucidate the pathophysiology of compartment syndrome.
  • To define the relationship between pressure, blood flow, and tissue viability.
  • To clarify the determinants of nerve and muscle pressure tolerance.

Summary:

  • Increased pressure within a fascial compartment compromises capillary blood flow and tissue function.
  • Pathophysiology involves a decreased arteriovenous pressure gradient, leading to reduced tissue oxygenation (PO2) and metabolic deficits.
  • Tissue tolerance is dictated by the mean arterial pressure to tissue pressure gradient, not absolute tissue pressure.

Impact:

  • Provides a foundational understanding of compartment syndrome for clinicians.
  • Highlights the critical role of the arteriovenous gradient in tissue perfusion.
  • Informs diagnostic criteria and management strategies for compartment syndrome.

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