None listed
Conditions
Brief summary
Compartment syndrome occurs when swelling in a muscle interferes with the blood supply to that muscle. The syndrome happens most often in fractures, and after bone operations, and can lead to damage to the muscle and nerves of the limb affected. We are interested in using a new technology that is designed to look at the blood oxygen levels in tissue (in this case muscle). The technology uses probes attached to a machine. The probes are placed on the skin, and shine light into the muscle. The light is not damaging to the tissue. We would like to know more about the oxygen levels of muscles in compartment syndrome in children. All children 0 to 18 years of age can participate. They cannot participate if they have jaundice, or broken skin where the probes may be placed. For those presenting with suspected compartment syndrome, when the child comes to theatre, once they are asleep, we will place a probe on the skin over the muscle. We will do this on the affected and the unaffected side. We will also do a standard compartment pressure measurement simultaneously. The probe will be left on for 2 minutes in theatre, and then removed. For those presenting with a supracondylar fracture, the probes will be placed on the injured, and uninjured sides and left on for 48 hours or until hospital discharge. The monitor has not yet been shown to help in this problem, and we will not use the values to alter treatment in any way. We hope that the results of this study will help us to detect compartment syndrome early on, and allow quicker treatment, in those children who develop it.
Interventions
Observation of tissue oxygenation levels using near infrared spectroscopy.
Near infrared spectroscopy is a completely non-invasive optical method that utilizes near infrared light to ascertain the average oxygen saturation of haemoglobin in a region of tissue. The method is closely related to standard plethysmographic oxygen saturation measurement(SpO2), and is currently used in cardiac surgery to measure brain tissue oxygenation during cardiopulmonary bypass, and in intensive care. It is also u
Observation of tissue oxygenation levels using near infrared spectroscopy. Near infrared spectroscopy is a completely non-invasive optical method that utilizes near infrared light to ascertain the average oxygen saturation of haemoglobin in a region of tissue. The method is closely related to standard plethysmographic oxygen saturation measurement(SpO2), and is currently used in cardiac surgery to measure brain tissue oxygenation during cardiopulmonary bypass, and in intensive care. It is also used in sports science to study real-time muscle oxygen kinetics, and is being investigated in a variety of areas. Group 1 involves patients presenting with grade 3 supracondylar fractures. NIRS monitoring of the injured and uninjured sides is commenced at the end of surgery for up to 48 hours or discharge, in addition to standard post operative monitoring(pain scores, range of motion, swelling). Group 2 involves patients presenting with suspected compartment syndrome. In these patients a single discrete 2 minute NIRS measurement is made immediately prior to surgery, co-temporaneously with invasive compartment pressure measurement. At surgical fasciotomy, the muscle is assessed for signs of compartment syndrome(swelling, colour, response to stimulation) The current planned duration is 1 year, with group 1 recruitment of 30 and group 2 recruitment of 10.
Sponsors
The Children's Hospital at Westmead
Eligibility
Sex/Gender
All
Age
2 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
Grade 3 supracondylar fracture for group 1 Clinically suspected compartment syndrome for group 2
Exclusion criteria
volar forearm skin damage preventing probe attachment Jaundice
Outcome results
None listed