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Compartment Syndrome

Conditions in which increased pressure within a limited space compromises the blood circulation and function of tissue within that space. Some of the causes of increased pressure are trauma, tight dressings, hemorrhage, and exercise. NIH - National Library of Medicine

About Compartment Syndrome

In many parts of the body, muscles (along with the nerves and blood vessels that run alongside and through them) are enclosed in a "compartment" formed of a tough membrane called fascia. When muscles become swollen, they can fill the compartment to capacity, causing interference with nerves and blood vessels as well as damage to the muscles themselves. The resulting painful condition is referred to as compartment syndrome.

Compartment syndrome may be caused by a one-time traumatic injury (acute compartment syndrome), such as a fractured bone or a hard blow to the thigh, by repeated hard blows (depending upon the sport), or by ongoing overuse (chronic exertional compartment syndrome), which may occur, for example, in long-distance running. NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases

What works? Research summarized

Evidence reviews

Fasciotomy wounds associated with acute compartment syndrome: a systematic review of effective treatment

Bibliographic details: Walker M, Kralik D, Porritt K.  Fasciotomy wounds associated with acute compartment syndrome: a systematic review of effective treatment. JBI Database of Systematic Reviews and Implementation Reports 2014; 12(1): 101-175 Available from: http://www.joannabriggslibrary.org/jbilibrary/index.php/jbisrir/article/view/1064

Acute traumatic compartment syndrome: a systematic review of results of fasciotomy

This review assessed diagnosis and treatment of acute compartment syndrome with fasciotomy and concluded that mortality and morbidity outcomes were better if fasciotomies are performed within six hours of the onset of symptoms. The review question was unclear and most aspects of the review process were poorly reported and as a result the reliability of the conclusion is uncertain.

Decompressive laparotomy for abdominal compartment syndrome: a critical analysis

INTRODUCTION: Abdominal compartment syndrome (ACS) is increasingly recognized in critically ill patients, and the deleterious effects of increased intraabdominal pressure (IAP) are well documented. Surgical decompression through a midline laparotomy or decompressive laparotomy remains the sole definite therapy for ACS, but the effect of decompressive laparotomy has not been studied in large patient series.

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Summaries for consumers

Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome (OHSS) is a complication of using hormones to induce ovulation (the release of eggs) in IVF (in vitro fertilization). The hormones can sometimes over‐stimulate the ovaries. Severe OHSS can be life threatening. One method used to try and reduce the risk of OHSS is 'coasting' or 'prolonged coasting'. This involves withholding one hormone (gonadotrophin) before ovulation. There was no evidence to suggest any benefit of withholding gonadotrophins (coasting) after ovulation in IVF for the prevention of OHSS (ovarian hyperstimulation syndrome) or in live births compared with no coasting or other interventions.

Embryo freezing for preventing ovarian hyperstimulation syndrome

More research is needed to determine whether using frozen embryos and or intravenous albumin can reduce the rate of severe ovarian hyperstimulation syndrome in IVF. Ovarian hyperstimulation syndrome (OHSS) is a complication of using hormones to induce ovulation (stimulate the release of eggs) in IVF (in vitro fertilisation). The drugs can sometimes over‐stimulate ovaries. Severe OHSS can be life‐threatening. Fewer hormones are needed if frozen embryos are transferred in a subsequent cycle, although this lowers pregnancy rates. However, this update the review first published in 2002 (D'Angelo 2002) found there is not enough evidence to show whether using frozen embryos and or intravenous albumin infusion (artificial fluid to increase the woman's blood volume) can reduce OHSS in women who are at high risk. More research is needed on effects on pregnancy rates.

Intramedullary nailing treat tibial shaft fractures in adults

Fractures of the tibial shaft (breaks in the bone situated in the long middle section of the tibia or shin bone) are mostly caused by high‐energy trauma, such as motor vehicle accidents. One commonly used method of fixation is intramedullary nailing. This involves the insertion of a metal rod, usually from the upper side of the tibia, into the inner cavity (medulla) of the tibia. The rod is generally held in place by screws. An available and widely used surgical technique of intramedullary nailing is inserting intramedullary nails with reaming (the bone cavity is reamed, before inserting the nail into the bone cavity space) or without reaming. This review looked at the evidence from trials comparing various types of intramedullary nailing.

More about Compartment Syndrome

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Other terms to know:
Fascia, Hemorrhage

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