Compression sonography for non-invasive measurement of lower leg compartment pressure in an animal model.

Bloch, Andreas; Tomaschett, Corina; Jakob, Stephan; Schwinghammer, Andreas; Schmid, Timo (2018). Compression sonography for non-invasive measurement of lower leg compartment pressure in an animal model. Injury - international journal of the care of the injured, 49(3), pp. 532-537. Elsevier 10.1016/j.injury.2017.11.036

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INTRODUCTION Compression ultrasound is a non-invasive technique allowing for qualitative visualization and quantitative measurements of mechanical tissue properties. In acute compartment syndrome (ACS), cadaver studies have proven that the intra-compartmental pressure (ICP) measured by compression sonography correlates with the ICP measured invasively. This study aimed to evaluate compression sonography for compartment pressure measurements in an animal model. MATERIAL AND METHODS The pressure in the anterior tibial compartment of 6 domestic pig legs was increased from baseline to 40mmHg in 5mmHg steps. Using compression sonography, the compartment diameter was measured without external pressure and during manual application of five levels of external pressure. The elasticity ratio (ER) was computed as the ratio of the compartment diameter with and without external pressure. At 40mmHg of external pressure the ERs at different ICP levels were compared using repeated ANOVA measurements. Post-hoc comparisons evaluated the lowest detectable ICP fulfilling the definition of ACS (ICP≥30mmHg) by starting from each pressure below 30mmHg (baseline, 20mmHg and 25mmHg, respectively). Receiver operator characteristic analyses defined ER limits with appropriate sensitivity and specificity to detect ACS. RESULTS The ER increased from 79.0% at baseline ICP to 89.3% at 40mmHg ICP. The ER at baseline and at 20mmHg ICP significantly differed from the ER at 30mmHg ICP (p=0.007 and 0.002, respectively); the ER at 25mmHg ICP significantly differed from the ER at 40mmHg ICP (p=0.001). An ER less than 87.1% had a sensitivity of 94.4% and a specificity of 88.9% to proper diagnosis of ACS. CONCLUSION Compression sonography might offer a non-invasive technique to guide treatment in cases of uncertain acute compartment syndrome. Further studies are needed to collect elasticity ratio data in humans and to clinically validate compression sonography for compartment pressure measurements.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Bloch, Andreas; Jakob, Stephan; Schwinghammer, Andreas and Schmid, Timo Georg Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0020-1383

Publisher:

Elsevier

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

30 Jan 2018 12:56

Last Modified:

23 Oct 2019 02:51

Publisher DOI:

10.1016/j.injury.2017.11.036

PubMed ID:

29195681

Uncontrolled Keywords:

Acute compartment syndrome Compression sonography Lower extremity trauma Non-invasive measurement Sonography

BORIS DOI:

10.7892/boris.108686

URI:

https://boris.unibe.ch/id/eprint/108686

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