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Related Experiment Videos

Muscle Microvascular Blood Flow, Oxygenation, pH, and Perfusion Pressure Decrease in Simulated Acute Compartment

Sravya T Challa1, Alan R Hargens, Amarachi Uzosike

  • 11Department of Orthopaedic Surgery, UC San Diego Medical Center, University of California, San Diego, San Diego, California.

The Journal of Bone and Joint Surgery. American Volume
|September 6, 2017
PubMed
Summary

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Diagnosing acute compartment syndrome (ACS) can be improved by measuring muscle hemodynamics and oxygenation. This study shows these parameters decrease significantly with increased intramuscular pressure (IMP), offering potential noninvasive diagnostic tools.

Area of Science:

  • Biomedical Engineering
  • Physiology
  • Surgical Diagnostics

Background:

  • Current acute compartment syndrome (ACS) diagnosis relies on clinical signs and invasive intramuscular pressure (IMP) measurements.
  • IMP measurement has limitations including pain, infection risk, and lack of diagnostic specificity.

Purpose of the Study:

  • To evaluate muscle hemodynamics, oxygenation, and pH as potential diagnostic parameters for ACS.
  • To test the hypothesis that increased IMP reduces muscle microvascular blood flow, oxygenation, and pH, especially with leg elevation.

Main Methods:

  • Simulated ACS using a pneumatic leg pressure chamber and venous stasis cuff in 8 healthy subjects.
  • Measured muscle microvascular blood flow, oxygenation, and pH using photoplethysmography and near-infrared spectroscopy-pH sensors.

Related Experiment Videos

  • Applied varying IMP levels (40-60 mm Hg) with legs at heart level and elevated 12 cm.

    • Main Results:

    • Increased IMP significantly decreased muscle microvascular blood flow (p=0.01), oxygenation (p<0.001), and pH (p<0.001).
    • Leg elevation further reduced muscle oxygenation (p=0.013) and perfusion pressure (p=0.03) at all IMP levels.

    Conclusions:

    • Muscle hemodynamics, oxygenation, and pH significantly decrease with rising IMP in a human ACS model.
    • Hemodynamic and metabolic parameters show promise as noninvasive diagnostic tools for ACS.