Phonomyography as a non-invasive continuous monitoring technique for muscle ischemia in an experimental model of acute compartment syndrome |
| |
| Institution: | 1. Department of Orthopaedic Surgery, McGill University, Montreal, Canada;2. Department of Radiology, Université de Montréal, Montreal, Canada;3. Department of Orthopaedic Surgery, Shriners Hospital for Children, McGill University, Montreal, Quebec, Canada;4. Département de pathologie et de microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, Canada;5. Department of Anesthesia, McGill University, Montreal, Canada;1. Center for Musculoskeletal Surgery, Spine Surgery Unit, Charité – University Medicine Berlin, Germany;2. Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany;3. Department of Orthodontics, University Hospital Mainz, Mainz, Germany;4. Department of Orthopaedics and Trauma Surgery, University Hospital Dresden, Germany;1. Academic Department of Trauma and Orthopaedics, Floor D, Clarendon Wing, LGI, University of Leeds, Leeds, UK;2. NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK;1. IEQ Clinica, Floor 3rd Office 3-4, 110 Street, Los Mangos Neighborhood, Valencia 2001, Venezuela;2. Valle de San Diego Medical Center, Floor 1st, Office: 18, Don Julio Centeno Avenue, El Morro 2 Neighborhood, San Diego District, Carabobo State, Venezuela;1. Department of Surgery, Melbourne Medical School – Western Precinct, The University of Melbourne, St. Albans, VIC 3021, Australia;2. Western Health Outpatients Department, Western Health, Footscray, VIC, Australia;3. St Vincent’s Department of Surgery, University of Melbourne, Fitzroy, VIC, Australia;4. Australian Institute of Musculoskeletal Science, Sunshine Hospital, St. Albans, VIC, Australia;5. Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville 3052, Australia;6. Melbourne Medical School – Western Precinct, The University of Melbourne, St. Albans, VIC 3021, Australia;1. Department of OrthopaedicSurgery, Bio-medical Research Institute, Pusan National University Hospital, Korea;2. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea |
| |
| Abstract: | BackgroundIn acute compartment syndrome (ACS), clinicians have difficulty diagnosing muscle ischemia provoked by increased intra-compartmental pressure in a timely and non-invasive manner. Phonomyography records the acoustic signal produced by muscle contraction. We hypothesize that alterations in muscle contraction caused by muscle ischemia can be detected with phonomyography, serving as a potential non-invasive technique in the detection of ACS.MethodsThe left hind limb of 15 Sprague-Dawley rats was submitted to a reversible ischemic model of limb injury for 30 min and 1, 2, 4, 6 h (3 rats in each group). The right limb served as control. Phonomyography microphones were placed over the posterior calf of both limbs and the sciatic nerve was stimulated percutaneously at 10-min intervals to evaluate muscle contraction. Histopathological analysis of muscles and nerves biopsies was performed and correlation was made between duration of injury, phonomyography output and degree of muscle and nerve necrosis.ResultsThere was a statistically significant decrease in the phonomyography signal output in the ischemic limb that correlated with the duration of ischemia and histological findings of muscle and nerve necrosis. The phonomyography signal decrease and histological findings were respectively: 55.5% (n = 15;p = 0.005) with rare muscle and nerve necrosis at 30 min, 65.6% (n = 12;p = 0.005) with 5–10% muscle necrosis at 1 h, 68.4% (n = 9;p = 0.015) with 100% muscle necrosis and little nerve damage at 2 h, 72.4% (n = 6;p = 0.028) with 100% muscle necrosis and severe nerve damage at 4 h, and 92.8% (n = 3;p = 0.109) with 100% muscle necrosis and severe nerve degeneration at 6 h.ConclusionChanges in phonomyography signal are observed in early ischemic injury prior to the onset of nerve or muscle necrosis. Therefore, phonomyography could serve as a non-invasive technique to detect early ischemic muscle changes in acute compartment syndrome.Clinical relevanceThe detection of abnormal muscle contraction in a timely fashion and non-invasive manner is of interest in clinical settings where the presence of ischemia is not easy to diagnose. |
| |
| Keywords: | Acute compartment syndrome Trauma Muscle injury Muscle ischemia Phonomyography Military injuries |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
