You are listening to the podcast, ICU rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director of the Burn Center of Vanderbilt Regional Burn

Center.

The topic that I would like to discuss today is extremity compartment syndrome.

Compartment syndromes occur whenever the pressure inside a particular anatomical area exceeds

the pressure which allows adequate blood flow and subsequent

delivery of oxygen and cellular nutrients. Left untreated, an extremity compartment syndrome

will lead to the destruction of muscular tissue resulting in myonecrosis or muscle death,

and that will ultimately result in the release of myoglobin and subsequent

renal failure. There are several things that can initiate this sequence of events, and this gets into the idea of a primary and secondary injury.

A primary injury, we need to think a lot like when we think about people who've had a traumatic brain injury.

In the case of

traumatic brain injury, a primary injury can be somebody hitting somebody in the head of the

baseball bat, a fall or a gunshot wound, and that results in primary organ damage in the brain. What

then follows is a inflammatory cascade that results in swelling of the brain.

And that swelling of the brain is frequently the most lethal component,

where it's what's called the secondary brain injury.

We have something very similar to that when we're talking about

abdominal, excuse me not abdominal, but extremity compartment syndromes,

that the primary insult may be the result of a traumatic event,

a fracture, a gunshot wound, a stab wound, or an ischemic event, such as an arterial injury.

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