Delayed Onset of Acute Limb Compartment Syndrome With Neuropathy After Venoarterial Extracorporeal Membrane Oxygenation Therapy
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초록
Acute limb compartment syndrome (ALCS) is defined as compound symptoms resulting from poor oxygenation and decreased nutrition supply to muscles and nerves in a tightly confined compartment. The most common cause of ALCS is tibia fracture, followed by blunt trauma to soft tissue. However, non-traumatic causes are rare. We report an iatrogenic, non-traumatic ALCS case after venoarterial extracorporeal membrane oxygen (VA-ECMO) therapy. A 14-year-old male received VA-ECMO therapy due to cardiorespiratory failure after drowning. Although he had no symptoms during therapy, leg swelling appeared 10 hours after ECMO treatment. Two days after the leg swelling, the patient underwent a fasciotomy. Unfortunately, nerve conduction studies and electromyography showed multiple neuropathies in the lower leg. Despite 2 weeks of rehabilitation with electrical stimulation, an exercise program, and physical therapy, there was no definite change in muscle strength. To our knowledge, this is the first reported case of non-traumatic ALCS after VA-ECMO therapy in Korea.
Abstract
Acute limb compartment syndrome (ALCS) is defined as compound symptoms resulting from poor oxygenation and decreased nutrition supply to muscles and nerves in a tightly confined compartment. The most common cause of ALCS is tibia fracture, followed by blunt trauma to soft tissue. However, non-traumatic causes are rare. We report an iatrogenic, non-traumatic ALCS case after venoarterial extracorporeal membrane oxygen (VA-ECMO) therapy. A 14-year-old male received VA-ECMO therapy due to cardiorespiratory failure after drowning. Although he had no symptoms during therapy, leg swelling appeared 10 hours after ECMO treatment. Two days after the leg swelling, the patient underwent a fasciotomy. Unfortunately, nerve conduction studies and electromyography showed multiple neuropathies in the lower leg. Despite 2 weeks of rehabilitation with electrical stimulation, an exercise program, and physical therapy, there was no definite change in muscle strength. To our knowledge, this is the first reported case of non-traumatic ALCS after VA-ECMO therapy in Korea.
참고문헌 (10)
- Malik AA, "Acute compartment syndrome: a life and limb threatening surgical emergency", J Perioper Pract, 19, pp.137~142 (2009)
- McQueen MM, "Acute compartment syndrome. Who is at risk?", J Bone Joint Surg Br, 82, pp.200~203 (2000)
- Moore RE 3rd, "Current concepts in pathophysiology and diagnosis of compartment syndromes", J Emerg Med, 7, pp.657~662 (1989)
- Elliott KG, "Diagnosing acute compartment syndrome", J Bone Joint Surg Br, 85, pp.625~632 (2003)
- Eltzschig HK, "Vascular ischaemia and reperfusion injury", Br Med Bull, 70, pp.71~86 (2004)
- Wall CJ, "Extracorporeal membrane oxygenation:an unusual cause of acute limb compartment syndrome", Anaesth Intensive Care, 38, pp.560~562 (2010)
- Percival TJ, "Reperfusion strategies in the management of extremity vascular injury with ischaemia", Br J Surg, 99(Suppl 1), pp.66~74 (2012)
- Reffelmann T, "No-reflow phenomenon persists long-term after ischemia", reperfusion in the rat and predicts infarct expansion, 2003, pp.108, 2911~2917
- 박순은, "Hyperkalemia in a patient with rhabdomyolysis and compartment syndrome -A case report-", Korean Journal of Anesthesiology, 59, pp.37~40 (2010), 대한마취통증의학회
- Sheridan GW, "Fasciotomy in the treatment of the acute compartment syndrome", J Bone Joint Surg Am, 58, pp.112~115 (1976)