RAISED INTRACOMPARTMENTAL PRESSURE AND COMPARTMENT SYNDROMES

Raised intracompartmental pressure (ICP) has become recognized as the final common pathway of a variety of pathologies which lend to failure of the microcirculation with resultant tissue hypoxia and cell death. While commonly seen after trauma, either accidental or operative, rai sed ICP may result from either an increase in the volume Of tissue wit hin a closed osseo-fascial or fascial compartment ol by the applicatio n of an external force compressing a compartment, and if is associated with a wide variety of insults. The advent of reproducible techniques of measuring ICP has added science to a well-recognized clinical pict ure and allowed a rational approach to management. Controversies still remain, particularly ii? regard to the level of pressure at which int ervention becomes mandatory and the role of prophylactic interventions . This review attempts to present current thinking on the pathophysiol ogy of the microcirculation and the background to these controversies. (C) 1998 Elsevier Science Ltd. All rights reserved.