PATHOPHYSIOLOGY OF THE COMPARMENT SYNDROME

本项目的总体目标是研究 肌内压升高引起的急性筋膜室综合征 短期和长期肌肉和神经测试的变量 功能 肌内压力由芯持续监测 法 短期试验将应用于急性心肌梗死的人类模型， 间隔综合征，而长期测试将遵循加压 犬前外侧区的自体血浆。 狗的研究将确定长期的，不可逆的肌神经损伤的阈值。 肌内注射不同幅度和持续时间的 压力 肌肉功能测试将包括等长抽搐扭矩， 啄张时间，一半松弛时间，等长强直扭矩， 和耐力。 功能变化将与肌肉相关 和神经形态学。 人类受试者的前室的外部压缩将 评估腓神经功能障碍的压力-时间阈值， 肌肉压力 该模型的结果将与 动脉血压，并将用于客观地确定最佳的 神经学技术用于评估急性， 前室综合征 在另一项研究中， 将在患者中确定膝关节位置对肌内压力的影响 胫骨骨折 最后，高压氧将用于治疗 减压前和减压后急性骨筋膜室综合征。 先前的狗的研究记录了肌肉坏死的显着减少 和水肿的症状 我们长远的目标是 提高急性骨筋膜室综合征的诊断和管理水平， 正常血压、高血压和低血压患者（例如， 震惊）。

The overall objective of this project is to study the pathophysiology of acute compartment syndromes by correlating elevated intramuscular pressure variables with short-term and long-term tests of muscle and nerve function. Intramuscular pressure is continuously monitored by the wick technique. Short-term tests will be applied to a human model of acute compartment syndrome, whereas long-term tests will follow pressurization of the canine anterolateral compartment by autologous plasma. Dog studies will determine thresholds of long-term, irreversible myoneural dysfunction after varying amplitudes and durations of intramuscular pressure. Tests of muscle function will include isometric twitch torque, time to peck tension, one-half relaxation time, isometric tetanic torque, and endurance capacity. Functional changes will be correlated with muscle and nerve morphology using light microscopy. External compression of the anterior compartment in human subjects will assess pressure-time thresholds of peroneal nerve dysfunction with elevated intramuscular pressure. Results with this model will be correlated with arterial blood pressures and will be used to determine objectively the best neurological technique for evaluating foot sensibility during an acute, anterior compartment syndrome. In a separate study, the effect of foot and knee position on intramuscular pressures will be determined in patients with tibial fracture. Finally, hyperbaric oxygen will be used to treat impendin and postdecompression acute compartment syndromes in patients. Previous studies of dogs document significant reductions of muscle necrosis and edema with hyperbaric oxygen treatment. Our long-term objective is to improve the diagnosis and management of acute compartment syndromes in patients with normal blood pressures, hypertension, and hypotension (e.g. shock).