Strauss MB
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, In.... Date of publication 2012 Jul 1;volume 39(4):847-55.
1. Undersea Hyperb Med. 2012 Jul-Aug;39(4):847-55.
The effect of hyperbaric oxygen in crush injuries and skeletal muscle-compartment
syndromes.
Strauss MB(1).
Author information:
(1)Hyperbaric Medicine, Long Beach Memorial Medical Center, Long Beach,
California, USA. mstrauss@memorialcare.org
Crush injuries represent a spectrum of injury to body parts as result of trauma.
Presentations vary from minor contusions to limb-threatening damage. Typically,
the injury involves multiple tissues, from skin and subcutaneous, to muscle and
tendons, to bone and joints. In their most severe presentations, predictable
complications--including osteomyelitis, non-union of fractures, amputations and
failed flaps--occur in approximately 50 percent of the cases with standard of
practice surgical and medical interventions. Skeletal muscle-compartment syndrome
(SMCS) is another consequence of trauma, but in this situation the target tissues
are muscles and nerve. Edema and/or bleeding within the confines of the fascial
envelope can increase the pressure within the skeletal muscle-compartment. When
the tissue fluid pressure within the compartment exceeds the capillary perfusion
pressure to the muscles and nerves in the compartment, these tissues are rendered
ischemic and manifest the signs and symptoms of SMCS. The SMCS, especially in its
incipient stages before a fasciotomy is required, is a therapeutic challenge
since no means to arrest its progression exist other than hyperbaric oxygen
(HBO2). Unfortunately, HBO2 is woefully neglected as an adjunct for managing
crush injury and SMCS. Strong arguments exist for its use based on
evidenced-based information and how HBO2 mitigates the pathology of these
conditions.
PMID: 22908841 [Indexed for MEDLINE]
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