Compartment syndrome elevation of the interstitial pressure in

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Compartment syndrome ภาวะทความดนภายในชองปดเพมสงขนมากจนกระทงรบกว นตอระบบ ไหลเวยนเลอด และการทางานของเนอเยอออนภายในชองนนๆ (elevation of the interstitial pressure in a closed

Compartment syndrome ภาวะทความดนภายในชองปดเพมสงขนมากจนกระทงรบกว นตอระบบ ไหลเวยนเลอด และการทางานของเนอเยอออนภายในชองนนๆ (elevation of the interstitial pressure in a closed osteofascial compartment that results in microvascular compromise) สวนใหญพบท Anterior and deep posterior compartments of the leg Volar compartment of the forearm

สาเหตของ compartment syndrome สาเหตสวนใหญ (most common causes) • Fractures • Soft tissue trauma •

สาเหตของ compartment syndrome สาเหตสวนใหญ (most common causes) • Fractures • Soft tissue trauma • Arterial injury • Limb compression during altered consciousness • Burns

PATHOPHYSIOLOGY

PATHOPHYSIOLOGY

PATHOPHYSIOLOGY Significant muscle necrosis can occur in patients with normal blood flow if intracompartmental

PATHOPHYSIOLOGY Significant muscle necrosis can occur in patients with normal blood flow if intracompartmental pressure is increased to more than 30 mm. Hg for longer than 8 hours. Higher pressures have been shown to cause greater compromise of neuromuscular viability in shorter periods of time.

CLINICAL EVALUATION 5 Ps • ปวด (pain) • อมพาต (paralysis) • ชา (paraesthesia) •

CLINICAL EVALUATION 5 Ps • ปวด (pain) • อมพาต (paralysis) • ชา (paraesthesia) • ชพจร (pulses and/or capillary refill) • ซด (pallor)และอณหภม (temperature)

CLINICAL EVALUATION Absence of clinical findings associated with compartment syndrome is more useful for

CLINICAL EVALUATION Absence of clinical findings associated with compartment syndrome is more useful for excluding the diagnosis than the presence of findings is for confirming the diagnosis.

Investigation If compartment syndrome is suspected an adequate examination cannot be performed, pressure levels

Investigation If compartment syndrome is suspected an adequate examination cannot be performed, pressure levels should be measured

Investigation Noninvasive methods • Ultrasonography measure submicrometer displacement of the fascia wall caused by

Investigation Noninvasive methods • Ultrasonography measure submicrometer displacement of the fascia wall caused by volume expansion of the muscle compartment (sensitivity 77% , specificity 93%) • Infrared imaging determine temperature diferences between the proximal and distal skin surfaces to help make the diagnosis of compartment syndrome

Investigation Invasive methods • Commercially available pressure monitor • Arterial line manometer • Whitesides

Investigation Invasive methods • Commercially available pressure monitor • Arterial line manometer • Whitesides three-way stopcock apparatus • Wick monitor

Commercially available pressure monitor

Commercially available pressure monitor

Arterial line manometer

Arterial line manometer

Whitesides three-way stopcock apparatus

Whitesides three-way stopcock apparatus

Wick monitor

Wick monitor

TREATMENT Compartmental pressures are greater than 30 mm Hg in the presence of clinical

TREATMENT Compartmental pressures are greater than 30 mm Hg in the presence of clinical findings, immediate fasciotomy is indicated In patients with major disruption of the arterial circulation or circumferential full- thickness burns, fasciotomy should be performed at the time of initial surgery

Fasciotomy

Fasciotomy

Fasciotomy

Fasciotomy

Fasciotomy

Fasciotomy

Thank You

Thank You

COMPARTMENT SYNDROME INTRODUCTION Compartment syndrome CS is aCOMPARTMENT SYNDROME INTRODUCTION Compartment syndrome CS is a
Compartment Syndrome Abdominal Compartment Syndrome z Done ByCompartment Syndrome Abdominal Compartment Syndrome z Done By
Compartment Syndrome By Patti Hamilton DEFINITION Compartment syndromeCompartment Syndrome By Patti Hamilton DEFINITION Compartment syndrome
Compartment Syndrome Introduction Acute Compartment Syndrome occures whenCompartment Syndrome Introduction Acute Compartment Syndrome occures when
Radiological syndroms Alveolar syndrome Bronchial syndrome Interstitial syndromeRadiological syndroms Alveolar syndrome Bronchial syndrome Interstitial syndrome
Acute Compartment Syndrome Viktoras Kubaitis 10092012 Acute CompartmentAcute Compartment Syndrome Viktoras Kubaitis 10092012 Acute Compartment
Pressure and Pressure Scales Pressure A pressure isPressure and Pressure Scales Pressure A pressure is
The Pressure of Compartment Syndrome Kathleen Byington RNThe Pressure of Compartment Syndrome Kathleen Byington RN
The Pressure of Compartment Syndrome Kathleen Byington RNThe Pressure of Compartment Syndrome Kathleen Byington RN
Autonomic nervous system ANS central compartment peripheral compartmentAutonomic nervous system ANS central compartment peripheral compartment
COMPARTMENT SYNDROM Robert Dokke ort avd SF COMPARTMENTCOMPARTMENT SYNDROM Robert Dokke ort avd SF COMPARTMENT
Autonomic nervous system ANS central compartment peripheral compartmentAutonomic nervous system ANS central compartment peripheral compartment
Anterior Compartment of Leg Anterior Compartment of LegAnterior Compartment of Leg Anterior Compartment of Leg
Anterior Compartment of Leg Anterior Compartment of LegAnterior Compartment of Leg Anterior Compartment of Leg
MiniOpen Posterior Compartment Release for Chronic Exertional CompartmentMiniOpen Posterior Compartment Release for Chronic Exertional Compartment
Medial Compartment of Thigh The medial compartment ofMedial Compartment of Thigh The medial compartment of
Lower limb post Compartment of Leg Posterior CompartmentLower limb post Compartment of Leg Posterior Compartment
INTERSTITIAL LUNG DISEASES ILD DEFINITION Interstitial lung diseasesINTERSTITIAL LUNG DISEASES ILD DEFINITION Interstitial lung diseases
Interstitial Lung Disease Organization of Interstitial Lung DiseaseInterstitial Lung Disease Organization of Interstitial Lung Disease
Interstitial Lung Disease Organization of Interstitial Lung DiseaseInterstitial Lung Disease Organization of Interstitial Lung Disease
Notes from the Underground South Elevation Northwest ElevationNotes from the Underground South Elevation Northwest Elevation
Angles of Elevation 8 4 Angles of ElevationAngles of Elevation 8 4 Angles of Elevation
Angles of Elevation 8 4 Angles of ElevationAngles of Elevation 8 4 Angles of Elevation
Differential Diagnosis of ST Segment Elevation ST ElevationDifferential Diagnosis of ST Segment Elevation ST Elevation