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ABSTRACT
A simple method was investigated to measure compartment pressures using 16-ga intravenous catheters with or without side ports attached by arterial line tubing to a pressure transducer. Pressure measurements from the experimental catheters were within 4 mm Hg of the slit catheter for 99% of all readings, and pressure measurements from the Stryker device were within 5 mm Hg of the slit catheter for 95% of all readings. The addition of one or two side ports to the experimental catheters did not alter the pressure readings. This method is comparable in accuracy to the slit catheter and in simplicity to the Stryker device.
Compartment syndrome results when the pressure within a fasciai compartment becomes elevated such that blood circulation is compromised. Tissue ischemia leading to Volkmann 's contractures1 eventually can result unless a fasciotomy is performed.2 Methods of measuring compartment pressures have been developed to help clinicians determine when fasciotomy is indicated.
In 1884, Landerer3 first measured tissue pressures by using a needle attached to a mercury manometer. Whitesides et al4 popularized the use of needle manometry to diagnose compartment syndrome in 1975. However, their method is awkward for one person to use because a reading from the mercury manometer must be made while controlling the injection syringe and watching the movement of the airwater meniscus. Subsequently, other devices have been developed to measure compartment pressures including the wick catheter,5 the slit catheter,6 the Solid-State Transducer Intracompartment Catheter (STlC),7 the Myopress catheter,8 the Stryker device,9 and a "transducer-tipped" fiberoptic catheter.10
The wick catheter is not used often because its frequency response is slow and elements of the wick can break off while in muscle. The STIC device and transducer-tipped fiberoptic devices are used primarily in experimental protocols because the catheters are expensive to replace. Although more accurate than a simple needle, the slit catheter must be advanced within a large-bore introducer, thus causing more tissue trauma and patient discomfort. The Stryker device has enjoyed considerable popularity due to its portability and ease of use; however, this instrument is relatively expensive and is awkward to use in a sterile setting.
A manometer also can be made from materials readily available in any emergency room, intensive care unit, or operating room. A 16-ga intravenous...