Intracompartmental Pressures

The Mikro-Cath™ Pressure Catheter delivers high-fidelity, pressure waveform data for analysis of intracompartmental pressure measurements. Simple, accurate signals from the solid-state pressure sensor catheter provide continuous, real-time assessments to support the diagnosis of acute compartment syndrome (ACS) or evaluation of chronic exertional compartment syndrome (CECS).

 

Support Compartment Syndrome Diagnosis

Mikro-Cath high-fidelity pressure measurements provide orthopedic trauma surgeons with reliable pressure signals to support and simplify the diagnosis of compartment syndrome for trauma patients. As a compartment pressure measurement device, the Mikro-Cath pressure catheter also supports orthopedic research and sports medicine physicians who monitor chronic exertional compartment syndrome and can be used in exercise studies due to the solid-state pressure sensor's stability. This stability delivers reliable, accurate measurements even during patient movement.

With an appropriately sized introducer, the Mikro-Cath can be easily inserted into the targeted muscle compartment for continuous measurements up to 24 hours.

The Mikro-Cath is a viable alternative to the previous Stryker compartment pressure monitor (now C2DX STIC intra-compartmental pressure monitor) and provides the advantage of continuous pressure monitoring, reliable signals, and ease of use. With the catheter tip at only 3.5F (1.17 mm), the puncture wound is smaller than other catheter options. Patient movement also does not interfere with the signal quality compared to fluid-filled devices.

Consider the Mikro-Cath for compartment pressure monitoring and early detection of compartment syndrome to avoid irreversible damage or to prevent misdiagnosis.

With the Mikro-Cath, clinicians can obtain more comprehensive and accurate measurements for:

• Acute Compartment Syndrome Diagnosis
• Chronic Exertional Compartment Syndrome

Compartment syndrome can impact the lower and upper extremities as well as the compartments of the hand, foot, and gluteal region. Acute compartment syndrome typically occurs from trauma but can occur with an underlying medical condition that causes an increase in fluid volume within a compartment.

While there is still debate on when compartment pressures become detrimental to the surrounding tissue and nerves, a common practice is to monitor for a delta pressure of 30 mmHg or less for greater than two hours. The delta pressure is the difference between the diastolic blood pressure of a patient and the pressure of the compartment measured (ΔP = diastolic - intracompartmental pressure)¹. The pressure is caused by muscle swelling or bleeding that is constricted by the fascia. The swelling disrupts blood flow to the muscle and nerve cells, decreasing oxygen and nutrients. This condition becomes very painful and can lead to tissue and nerve damage within the extremity affected. To avoid permanent damage in acute compartment syndrome, the patient must be treated with a fasciotomy within the first 4 hours².

Benefits of Continuous Compartment Pressure Monitoring

Can you confidently diagnosis compartment syndrome? Consider the benefits of continuous monitoring when measuring intracompartmental pressures.

According to a 2004 study, compartment syndrome diagnosis is one of the most common sources of litigation against orthopedic surgeons. The average cost of a settlement for undiagnosed compartment syndrome has been cited at $426,000.30. There is value in bringing higher confidence back into the equation.

The Mikro-Cath offers improved sensitivity and specificity over existing methods in the diagnosis of anterior compartment CECS by obtaining continuous, high fidelity data. Benefits include:

• Ability to evaluate average pressure trends and assess data in real-time
• Knowing exact time when pressures cross and sustain threshold levels
• Reduces stress to the patient to have one catheter introduced compared to multiple needle insertions every 1 to 2 hours for up to 24 hours as required by traditional single point monitoring systems
• Fewer pressure measurements/procedures (time) needed from a physician
• Less risk of false measurements with solid-state sensor technology (air bubbles/proper calibration/angle/patient movement)
• More cost effective if monitoring for extended periods of time

¹McQueen M.M., Court-Brown C.M. Compartment Monitoring in Tibial Fractures: The Pressure Threshold for Decompression. JBJS [Br] 1996; 78-B-:99-104

²Hasnain Raza and Anant Mahapatra, “Acute Compartment Syndrome in Orthopedics: Causes, Diagnosis, and Management,” Advances in Orthopedics, vol. 2015, Article ID 543412, 8 pages, 2015. doi:10.1155/2015/543412

³David Roscoe, MRCGP, MFSEM(UK), MSc(SEM), DipIMC RCSEd, MPA, Andrew J.Roberts, MSc, David Hulse, MB ChB, MSc, FFSEM(UK), "Intramuscular Compartment Pressure Measurement in Chronic Exertional Compartment Syndrome: New and Improved Diagnostic Criteria," The American Journal of Sports Medicine, Vol 43, Issue 2, pp. 392 - 398.

Olson A, Rhorer A. Orthopaedic trauma for the general orthopaedist. Clin Orthop Rel Res [Internet]. 2005 [cited 2015 Jan]; 433;30-7. Available from http://www.researchgate.net/publication/7930149_Orthopaedic_trauma_for_the_general
_orthopaedist_avoiding_problems_and_pitfalls_in_treatment

Bhattacharyya T, Vrahas M. The medical-legal aspects of compartment syndrome. J Bone Joint Surg Am [Internet]. 2004 Apr [cited 2015 Jan]; 86-A(4);864-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15069156