Compartmental pressure measurements during application of the pneumatic antishock garment

Recent case reports have implicated the pneumatic antishock garment (PASG) in the development of the compartment syndrome in the lower extremities. The present study used the anterolateral compartment of the canine hindlimb to model the effect of the PASG on tissue pressure within the compartment (Pc). Prior to inflation of the garment, baseline Pc was 5.3 mm Hg. PASG inflation to 60 mm Hg for 20 minutes resulted in an increase in Pc of 75.0 mm Hg over baseline values. The rise in Pc was reduced significantly following hemorrhage of the animal, measuring 65.8 mm Hg at a mean arterial pressure of 70 to 80 mm Hg and 62.5 mm Hg at a mean arterial pressure of 40 to 50 mm Hg. In the immediate postarrest state, Pc rise after a five-minute inflation of the garment was 57.5 mm Hg. In all cases, Pc promptly returned to baseline values when the PASG was deflated, and there was no significant change in Pc following deflation of the garment under conditions of normotension, hemorrhagic hypotension, and in the immediate postarrest state. Our results suggest that the level of arterial pressure may contribute to Pc rise during PASG inflation.