The Journal of Bone and Joint Surgery, Vol 68, Issue 8 1218-1224, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Hyperbaric oxygen reduces edema and necrosis of skeletal muscle in compartment syndromes associated with hemorrhagic hypotension
MJ Skyhar, AR Hargens, MB Strauss, DH Gershuni, GB Hart and WH Akeson
This study examined the effect of exposures to hyperbaric oxygen on the
development of the edema and necrosis of muscle that are associated with
compartment syndromes that are complicated by hemorrhagic hypotension. A
compartment syndrome (twenty millimeters of mercury for six hours) was
induced by infusion of autologous plasma in the anterolateral compartment
of the left hind limb of seven anesthetized dogs while the mean arterial
blood pressure was maintained at sixty-five millimeters of mercury after 30
per cent loss of blood volume. These dogs were treated with hyperbaric
oxygen (two atmospheres of pure oxygen) and were compared with six dogs
that had an identical compartment syndrome and hypotensive condition but
were not exposed to hyperbaric oxygen. Forty-eight hours later, edema was
quantified by measuring the weights of the muscles (the pressurized muscle
compared with the contralateral muscle), and necrosis of muscle was
evaluated by measuring the uptake of technetium-99m stannous pyrophosphate.
The ratio for edema was significantly (p = 0.01) greater in dogs that had
not been exposed to hyperbaric oxygen (1.15 +/- 0.01) than in the dogs that
had been treated with hyperbaric oxygen (1.01 +/- 0.03), and the ratio for
necrosis of muscle was also significantly (p = 0.04) greater in dogs that
had not had hyperbaric oxygen (1.96 +/- 0.41) than in those that had been
treated with hyperbaric oxygen (1.05 +/- 0.11). Comparisons were also made
with the muscles of four normal control dogs and separately with the
muscles of six normotensive dogs that had an identical compartment syndrome
and normal blood pressure and were not treated with hyperbaric
oxygen.(ABSTRACT TRUNCATED AT 250 WORDS)
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