From the Guidelines
A delta pressure of less than 30 mmHg is consistent with a diagnosis of compartment syndrome. When the compartment pressure rises to within 30 mmHg of the diastolic pressure, this indicates compromised tissue perfusion and is diagnostic for compartment syndrome 1. Some key points to consider in the diagnosis of compartment syndrome include:
- Clinical signs such as pain out of proportion to injury, pain on passive stretch, paresthesia, pallor, paralysis, and pulselessness (though this is often a late finding) 1
- Measurement of compartment pressure using a pressure monitor inserted directly into the suspected compartment
- The importance of prompt recognition and treatment, as compartment syndrome represents a surgical emergency requiring immediate fasciotomy to prevent permanent tissue damage 1 In terms of specific delta pressure values, a delta pressure of 30 mmHg or less is considered consistent with a diagnosis of compartment syndrome, with some clinicians using an even more conservative threshold of less than 20-25 mmHg 1. Key factors to consider in the management of compartment syndrome include:
- Early fasciotomy in case of recently formed compartment syndrome
- The importance of volume resuscitation to prevent acute kidney injury and the need for renal replacement therapy 1
- The need for prompt recognition and treatment to prevent permanent tissue damage and improve patient outcomes 1
From the Research
Delta Pressure Consistent with Compartment Syndrome
- A delta pressure of less than 30 mmHg is consistent with a diagnosis of compartment syndrome, as stated in studies 2, 3.
- This is calculated by subtracting the compartment pressure from the diastolic blood pressure.
- The options provided are:
- 30 mm Hg
- 35 mm Hg
- 40 mm Hg
- 45 mm Hg
- Based on the evidence, a delta pressure of less than 30 mmHg is indicative of compartment syndrome, so none of the provided options exactly match this criterion.
- However, it can be inferred that a delta pressure of 30 mm Hg or less would be consistent with a diagnosis of compartment syndrome, as stated in studies 2, 4, 5, 3.
- Study 6 suggests that using a delta pressure of 30 mmHg may result in a high false-positive rate, but this does not change the fact that a delta pressure of less than 30 mmHg is consistent with compartment syndrome.
- It is essential to consider the clinical presentation and other diagnostic factors in conjunction with delta pressure measurements, as emphasized in studies 4, 6, 3.