PRESSURE-FLOW RELATIONSHIPS IN IN-VITRO MODEL OF COMPARTMENT SYNDROME

被引:22
作者
SHRIER, I
MAGDER, S
机构
[1] SIR MORTIMER B DAVIS JEWISH HOSP,LADY DAVIS INST,MONTREAL,PQ H3T 1Z6,CANADA
[2] ROYAL VICTORIA HOSP,DIV CRIT CARE,MONTREAL,PQ H3A 1A1,CANADA
[3] MCGILL UNIV,MEAKINS CHRISTIE LABS,MONTREAL,PQ H3T 1Z6,CANADA
关键词
VASCULAR WATERFALL; CRITICAL CLOSING PRESSURE; ARTERIAL RESISTANCE; VENOUS RESISTANCE;
D O I
10.1152/jappl.1995.79.1.214
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Compartment syndrome is a condition in which an increase in intramuscular pressure decreases blood flow to skeletal muscle. According to the Starling resistor (i.e., vascular waterfall) model of blood flow, the decrease in flow could occur through an increase in arterial resistance (Rart) or an increase in the critical closing pressure (Pcrit). To determine which explains the decrease in flow, we pump perfused a canine gastrocnemius muscle placed within an airtight box, controlled box pressures (Pbox) so that flow ranged from 100 to 50%, and measured Pcrit, Rart, arterial compliance, small venular pressure (measured by the double-occlusion technique), and venous pressure. An increase in Pbox limited flow mainly through an increase in Pcrit (75-85%), with only small changes in Rart (15-25%) and no change in arterial compliance. Increases in Pbox also produced a vascular waterfall in the venous circulation, but small venular transmural pressure always remained less than control levels. We conclude that increases in Pbox mostly limit blood flow through increases in Pcrit and that Rart plays a minor role. Transmural pressure across the small venules decreases with increases in intramuscular pressure, which contradicts the currently held belief that compartment syndrome is due to a cycle of swelling-ischemia swelling.
引用
收藏
页码:214 / 221
页数:8
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