Article (Scientific journals)
In vivo optical spectroscopy monitoring in a new model of muscular compartment syndrome.
Forget, P.; Ponchon, F.; Vanhoonacker, M. et al.
2012In British Journal of Anaesthesia, 109 (4), p. 561-5
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Keywords :
Adult; Blood Pressure/physiology; Compartment Syndromes/diagnosis; Electromyography; Humans; Male; Monitoring, Physiologic/instrumentation/methods; Muscular Diseases/diagnosis; Nerve Block; Oximetry; Oxygen/blood; Pain Measurement/methods; Postoperative Complications/diagnosis; Predictive Value of Tests; Pressure; ROC Curve; Spectrum Analysis
Abstract :
[en] BACKGROUND: Muscular compartment syndrome (MCS) is a rare but serious postoperative complication. In vivo optical spectroscopy (INVOS) monitors continuously and non-invasively regional oxygen saturation (rSO(2)), and could predict the development of MCS. METHODS: In 10 healthy volunteers, we inflated a tourniquet to the mean arterial pressure to produce slight venous congestion and arterial hypoperfusion. Comparisons were made between the relative reduction in rSO(2) with baseline (deltaINVOS) and the time to observe motor nerve block (with non-invasive electromyography). Neurological symptoms, pain, and invasive intracompartmental pressure (ICP) were assessed. RESULTS: In the eight volunteers completing the protocol, we observed a profound motor nerve conduction block, immediately reversible. Baseline values were: [mean (sd)] INVOS: 73.3 (8.9)% and ICP: 16.9 (8.6) mm Hg. At the time of the block, values were: INVOS: 46.4 (10.9)%, deltaINVOS: 28.7 (10.6)%, and ICP: 70.0 (5.5) mm Hg. The time to reach the block was 33.0 (10.9) min, and to a deltaINVOS>10%: 27.4 (10.4) min. Receiver-operating characteristic curves demonstrated a similar accuracy of ICP and INVOS to predict the occurrence of the block. Twenty minutes with a deltaINVOS>10% or ICP>30 mm Hg were associated with a sensitivity and a specificity of 95% and 70%; or 91% and 65%, respectively. CONCLUSIONS: We have developed a model of acute immediately reversible MCS. Monitoring using the INVOS technology is as accurate as measurement of ICP, and could be a useful tool to prevent development of intraoperative MCS.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Forget, P.
Ponchon, F.
Vanhoonacker, M.
Stoquart, G. G.
Lejeune, T. M.
Lois, Fernande ;  Cliniques Universitaires Saint-Luc (Bruxelles) > Service d'anesthésie - réanimation
Kahn, D.
Schils, J. L.
De Kock, M.
Language :
English
Title :
In vivo optical spectroscopy monitoring in a new model of muscular compartment syndrome.
Publication date :
2012
Journal title :
British Journal of Anaesthesia
ISSN :
0007-0912
eISSN :
1471-6771
Publisher :
Elsevier, London, United Kingdom
Volume :
109
Issue :
4
Pages :
561-5
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 05 March 2017

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