New noninvasive ultrasound technique for monitoring perfusion pressure in a porcine model of acute compartment syndrome.
New noninvasive ultrasound technique for monitoring perfusion pressure in a porcine model of acute compartment syndrome.
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DOI：
10.1097/bot.0b013e31819901db
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发表时间：
2009-03
影响因子：
2.3
通讯作者：
Hargens AR
中科院分区：
文献类型：
--
作者：
Garabekyan T;Murphey GC;Macias BR;Lynch JE;Hargens AR
急性筋膜室综合征（ACS）是灌注压（PP）降低的结果，诊断通常需要侵入性监测。我们的目的是测试一种新的非侵入性超声设备，用于在ACS的受控猪模型中将PP与筋膜位移测量相关联。我们假设，实验室与受损的PP筋膜位移将显着大于正常的基线PP控制室。在7只麻醉猪的右前室中产生ACS，而对侧室作为正常对照。通过狭缝导管监测所有隔室中的肌内压（IMP），而通过输注0.045%白蛋白的生理盐水以10 mmHg的增量升高实验隔室中的IMP。一种非侵入性超声设备连续记录筋膜位移对应于动脉压力脉冲在所有隔室。将平均筋膜位移幅度按PP分组，并使用双向重复测量ANOVA和对比分析进行分析。由于PP范围为80至-40 mmHg，输注室的筋膜位移变化显著大于对照室（ANOVA，p = 0.03）。在40和-20 mmHg之间的每个PP增量下，输注室中的筋膜移位显著大于对照室中的筋膜移位（对比分析，p < 0.014）。筋膜移位在PP降低的肌肉隔室中显著更大。此外，PP的变化与临床相关PP范围内筋膜移位的变化相关，使得这种非侵入性技术可能用于ACS的监测。
Acute compartment syndrome (ACS) is the result of decreased perfusion pressure (PP) and the diagnosis frequently requires invasive monitoring. Our objective was to test a new non-invasive ultrasound device for correlating PP with measurements of fascial displacement in a controlled porcine model of ACS. We hypothesized that fascial displacement in experimental compartments with impaired PP would be significantly greater than that in control compartments with normal baseline PP. ACS was generated in right anterior compartments of seven anesthetized pigs while contralateral compartments served as normal controls. Intramuscular pressure (IMP) in all compartments was monitored by slit catheters while IMP in experimental compartments was elevated in 10 mmHg increments by infusing 0.045% albumin in saline. A non-invasive ultrasound device continuously recorded fascial displacement corresponding to arterial pressure pulses in all compartments. Mean fascial displacement amplitude was grouped by PP and analyzed using two-way repeated measures ANOVA and contrast analysis. As PP ranged from 80 to -40 mmHg, the change in fascial displacement of the infused compartments was significantly greater than that in the control compartments (ANOVA, p = 0.03). At each PP increment between 40 and –20 mmHg, fascial displacement in the infused compartments was significantly greater than that in the control compartments (contrast analysis, p < 0.014). Fascial displacement is significantly greater in muscle compartments with decreased PP. Furthermore, changes in PP are associated with changes in fascial displacement over a clinically relevant range of PP, making this non-invasive technique potentially useful for monitoring in ACS.