Continuous Intracompartmental Pressure Monitoring for Acute Compartment Syndrome
Andrew D Duckworth, Margaret M McQueen, Andrew D Duckworth, Margaret M McQueen
Abstract
Introduction: We recommended that all patients at risk for acute compartment syndrome undergo continuous intracompartmental pressure monitoring.
Step 1 patient consent: Provide thorough explanations so that the patient can give informed consent to undergo catheter placement and continuous compartment pressure monitoring.
Step 2 position the patient: Perform the procedure with the patient supine, in either the recovery room (post anesthetic care unit) or with adequate assistance on the ward.
Step 3 preparation: Have all required items for the slit catheter technique for continuous intracompartmental pressure monitoring with placement under a strict aseptic technique.
Step 4 insert the catheter: At the time of admission to the hospital, insert a slit catheter into the anterior compartment with the catheter tip within 5 cm of the fracture level and 1 to 2 cm lateral to the tibia.
Step 5 attach the transducer: Once the catheter is in position, fill it with normal saline solution and attach it to the transducer and pressure manometry tubing, providing a continuous column of saline solution between the compartment and the transducer.
Step 6 attach the transducer to the monitor and check reading: Once assembly is complete, you must check that the catheter is working properly and providing accurate readings; then measure the patient's blood pressure at the initial and every subsequent reading.
Step 7 continuous monitoring: Perform continuous monitoring for twenty-four hours or until the pressure is consistently dropping and the ΔP is consistently rising, whichever is the longer.
Results: In our previously published study, we examined 850 patients who underwent continuous intracompartmental pressure monitoring following a fracture of the tibial diaphysis.
What to watch for: IndicationsContraindicationsPitfalls & Challenges.
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Source: PubMed