Ultrasound characteristics of lower extremity venous blood flow for the early diagnosis of compartment syndrome

An experimental study

M. P. Ombrellaro, Scott Stevens, Michael Freeman, E. Walker, Mitchell Goldman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The purpose of this study was to investigate the utility of Doppler ultrasound characteristics of venous blood flow for the diagnosis of impending compartment syndrome. A compartment syndrome model was developed in six adult hound dogs. Pulse rate and systolic, diastolic, and mean arterial blood pressures were continuously monitored. Normal saline was infused into the right anterolateral hindlimb compartment in aliquots sufficient to raise intracompartmental pressure by 5-mmHg increments up to 40 mmHg. After each infusion, compartment pressures were measured and a femoral vein duplex Doppler study performed. Venous flow characteristics of respiratory phasicity and augmentation were assessed, and flow velocity was measured. Baseline compartment pressures and femoral vein flow velocities averaged 4.3 ± 0.3 mmHg and 24.6 ± 6.0 cm/sec, respectively. At normal compartment pressures, mean velocities ranged from 0 at end-inspiration to 138.6 ± 6.9 cm/sec during expiration. Loss of respiratory variation occurred at a mean compartment pressure of 16.2 ± 3.1 mmHg (95% confidence interval, 13-19 mmHg) and was associated with a continuous flow velocity of 43.1 ± 6.0 cm/sec. Loss of flow augmentation occurred at a mean compartment pressure of 22.9 ± 2.7 mmHg (95% confidence interval, 21-25 mmHg) and was associated with a continuous flow velocity of 55.4 ± 17.5 cm/sec. Loss of respiratory phasicity occurred at lower pressures and preceded loss of augmented flow (p < 0.001). In conclusion, venous flow velocity and Doppler ultrasound characteristics together are a reproducible, noninvasive means of detecting impending compartment syndrome in this canine model.

Original languageEnglish (US)
Pages (from-to)71-75
Number of pages5
JournalJournal of Vascular Technology
Volume20
Issue number2
StatePublished - 1996

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Compartment Syndromes
Early Diagnosis
Lower Extremity
Pressure
Doppler Ultrasonography
Femoral Vein
Arterial Pressure
Confidence Intervals
Hindlimb
Canidae
Heart Rate
Dogs

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Ultrasound characteristics of lower extremity venous blood flow for the early diagnosis of compartment syndrome: An experimental study",
abstract = "The purpose of this study was to investigate the utility of Doppler ultrasound characteristics of venous blood flow for the diagnosis of impending compartment syndrome. A compartment syndrome model was developed in six adult hound dogs. Pulse rate and systolic, diastolic, and mean arterial blood pressures were continuously monitored. Normal saline was infused into the right anterolateral hindlimb compartment in aliquots sufficient to raise intracompartmental pressure by 5-mmHg increments up to 40 mmHg. After each infusion, compartment pressures were measured and a femoral vein duplex Doppler study performed. Venous flow characteristics of respiratory phasicity and augmentation were assessed, and flow velocity was measured. Baseline compartment pressures and femoral vein flow velocities averaged 4.3 ± 0.3 mmHg and 24.6 ± 6.0 cm/sec, respectively. At normal compartment pressures, mean velocities ranged from 0 at end-inspiration to 138.6 ± 6.9 cm/sec during expiration. Loss of respiratory variation occurred at a mean compartment pressure of 16.2 ± 3.1 mmHg (95{\%} confidence interval, 13-19 mmHg) and was associated with a continuous flow velocity of 43.1 ± 6.0 cm/sec. Loss of flow augmentation occurred at a mean compartment pressure of 22.9 ± 2.7 mmHg (95{\%} confidence interval, 21-25 mmHg) and was associated with a continuous flow velocity of 55.4 ± 17.5 cm/sec. Loss of respiratory phasicity occurred at lower pressures and preceded loss of augmented flow (p < 0.001). In conclusion, venous flow velocity and Doppler ultrasound characteristics together are a reproducible, noninvasive means of detecting impending compartment syndrome in this canine model.",
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T1 - Ultrasound characteristics of lower extremity venous blood flow for the early diagnosis of compartment syndrome

T2 - An experimental study

AU - Ombrellaro, M. P.

AU - Stevens, Scott

AU - Freeman, Michael

AU - Walker, E.

AU - Goldman, Mitchell

PY - 1996

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N2 - The purpose of this study was to investigate the utility of Doppler ultrasound characteristics of venous blood flow for the diagnosis of impending compartment syndrome. A compartment syndrome model was developed in six adult hound dogs. Pulse rate and systolic, diastolic, and mean arterial blood pressures were continuously monitored. Normal saline was infused into the right anterolateral hindlimb compartment in aliquots sufficient to raise intracompartmental pressure by 5-mmHg increments up to 40 mmHg. After each infusion, compartment pressures were measured and a femoral vein duplex Doppler study performed. Venous flow characteristics of respiratory phasicity and augmentation were assessed, and flow velocity was measured. Baseline compartment pressures and femoral vein flow velocities averaged 4.3 ± 0.3 mmHg and 24.6 ± 6.0 cm/sec, respectively. At normal compartment pressures, mean velocities ranged from 0 at end-inspiration to 138.6 ± 6.9 cm/sec during expiration. Loss of respiratory variation occurred at a mean compartment pressure of 16.2 ± 3.1 mmHg (95% confidence interval, 13-19 mmHg) and was associated with a continuous flow velocity of 43.1 ± 6.0 cm/sec. Loss of flow augmentation occurred at a mean compartment pressure of 22.9 ± 2.7 mmHg (95% confidence interval, 21-25 mmHg) and was associated with a continuous flow velocity of 55.4 ± 17.5 cm/sec. Loss of respiratory phasicity occurred at lower pressures and preceded loss of augmented flow (p < 0.001). In conclusion, venous flow velocity and Doppler ultrasound characteristics together are a reproducible, noninvasive means of detecting impending compartment syndrome in this canine model.

AB - The purpose of this study was to investigate the utility of Doppler ultrasound characteristics of venous blood flow for the diagnosis of impending compartment syndrome. A compartment syndrome model was developed in six adult hound dogs. Pulse rate and systolic, diastolic, and mean arterial blood pressures were continuously monitored. Normal saline was infused into the right anterolateral hindlimb compartment in aliquots sufficient to raise intracompartmental pressure by 5-mmHg increments up to 40 mmHg. After each infusion, compartment pressures were measured and a femoral vein duplex Doppler study performed. Venous flow characteristics of respiratory phasicity and augmentation were assessed, and flow velocity was measured. Baseline compartment pressures and femoral vein flow velocities averaged 4.3 ± 0.3 mmHg and 24.6 ± 6.0 cm/sec, respectively. At normal compartment pressures, mean velocities ranged from 0 at end-inspiration to 138.6 ± 6.9 cm/sec during expiration. Loss of respiratory variation occurred at a mean compartment pressure of 16.2 ± 3.1 mmHg (95% confidence interval, 13-19 mmHg) and was associated with a continuous flow velocity of 43.1 ± 6.0 cm/sec. Loss of flow augmentation occurred at a mean compartment pressure of 22.9 ± 2.7 mmHg (95% confidence interval, 21-25 mmHg) and was associated with a continuous flow velocity of 55.4 ± 17.5 cm/sec. Loss of respiratory phasicity occurred at lower pressures and preceded loss of augmented flow (p < 0.001). In conclusion, venous flow velocity and Doppler ultrasound characteristics together are a reproducible, noninvasive means of detecting impending compartment syndrome in this canine model.

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