Measurement of cavity pressure according to Whitesides . method

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Phan Ngoc Toan - Emergency Medicine Doctor - Emergency Department - Vinmec Danang International Hospital.


Compulsion syndrome is an emergency medical emergency, diagnosed by measuring pressure in the cavity according to the Whitesides method. This is the optimal method to measure the pressure in the cavity quickly and accurately, helping doctors to have early treatment plans to avoid causing dangerous complications for the patient.

1. What is compartment syndrome?

In the trauma emergency, compartment syndrome is a large injury with sudden increase in pressure in the musculoskeletal compartments such as hematoma or edema causing pressure on the vascular bundles and nerves, causing ischemia. Lower extremity causes dangerous complications such as spastic muscle paralysis due to lack of muscle supply, limb necrosis, loss of sensation, motor paralysis...
Compression compartment syndrome if not handled quickly Soon it will cause many dangerous consequences for the patient:
Systemic consequences: Compression of capillary circulation causes tissue necrosis, if more than 4 hours causes Myoglobine urine and causes kidney failure, more than 8 hours causes damage injury cannot be recovered. A necrotic limb can cause a patient to develop metabolic acidosis with a high risk of death.
Local consequences: The patient may have an amputation or otherwise the function of that limb will be poor and tendons, muscles or joints often become stiff.
Causes of compartment syndrome are mainly accidental injuries in which:
Fractures account for up to 45%, including both closed and open fractures. Vascular lesions especially after late vascular anastomosis. Particularly severe soft tissue injuries are also at risk of cavity pressure formation. Patients who perform closed bone fusion surgery close the fascia layer too carefully after bone fusion or due to compression of the powder due to the lack of good padding, no longitudinal incision of the powder.

In addition to traumatic causes, compartment syndrome is also caused by a number of causes such as some blood diseases that cause bleeding and hematoma in the cavity, by infusion or by necrotic plaques from the outside. such as snake bite , burn pressure compartment
The most common site of compression causing cavity pressure on the human body include the shoulder, arm, buttock, thigh, especially the posterior calf and anterior leg space. hand.

2. Symptoms of compartment syndrome

Patients with posterior fractures feel like they are squeezing their calves and arms, although they have been treated for fractures by immobilization or adjustment, the pain is increasing more and more.
Swollen legs or arms, uncomfortable tightness Fingers or legs feel pain when moving, swelling, poor blood circulation compared to the healthy side. The pulse in the injured extremities is very weak or sometimes can't be caught. The patient has weaker movements, numbness or loss of sensation in the compressed limb.

3. Measuring cavity pressure according to Whitesides . method

To accurately determine the pressure of the cavity, the doctor will order to measure the pressure of the cavity according to the Whitesides method. To measure the pressure in the cavity, it is necessary to prepare a bottle of physiological saline, a large needle, a mercury sphygmomanometer, a three-pronged hose,...
The doctor will insert a large needle into the cavity and measure the pressure. hydrostatic of the water column physiological solution is injected into the cavity.
For normal people, the pressure measurement value will range from 8 mmHg to 10 mmHg. When the pressure measurement value according to Whitesides method is greater than 30 mmHg, the doctor will appoint a cavity incision to release the cavity pressure.

Currently, there are many methods and modern equipment, which are easy to implement and give more accurate results than this form (for example in Figure 2)

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