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      Hypertonic Mannitol Ameliorates Intracompartmental Tamponade in Model Compartment Syndrome in the Dog

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          Acute compartment syndrome (ACS) is a devastating complication of rhabdomyolysis caused by muscle tamponade secondary to increased intracompartmental pressure (Pi). ACS requires emergency surgical decompression when Pi > 30 mmHg (normal < 4.0 mmHg) and clinical signs exist. The present study was undertaken to examine whether mannitol which has been used extensively for prevention of acute renal failure in rhabdomyiolysis may also improve muscular hemodynamics in ACS. ACS was produced in dogs by injecting dog plasma into the anterolateral compartment of the hind limb. The Pi was directly monitored. Control dogs received saline, whereas experimental dogs received intravenously 20% mannitol (0.15 ml/min/kg) over a period of 1 h. The initial Pi was set arbitrarily at 100 mm Hg. Following the establishment of ACS, the spontaneous mean decrease in Pi in the control group was 40% of initial value over 60 min (n = 5) versus a decrease of 65%/60 min in the experimental (mannitol) group (n = 7, p < 0.01). The net mean decompressive effect of mannitol treatments was approximately 28 mm Hg (mean control Pi minus mean experimental Pi at time 60 min). Extrapolated to man with ACS, such a decrease in Pi induced by mannitol theoretically could relieve compartmental tamponade noninvasively.

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          Author and article information

          S. Karger AG
          11 December 2008
          : 58
          : 3
          : 344-346
          Departments of aNephrology, bOrthopedics ‘B’, and cPlastic and Reconstructive Surgery, Rambam Hospital, Haifa; dDepartment of Physiology and Biophysics, Faculty of Medicine and Rappaport Institute, Haifa, Israel.
          186448 Nephron 1991;58:344–346
          © 1991 S. Karger AG, Basel

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          Page count
          Pages: 3
          Original Paper

          Cardiovascular Medicine, Nephrology

          Muscle tamponade, Mannitol, Crush syndrome


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