Compartment syndrome--current trends in Scottish practice.
The results are reported of a postal survey into current trends in the management of compartment syndrome and the use of compartment pressure monitoring (CPM) within Scottish trauma units. The majority of consultants in the study felt that all patients, especially the obtunded, with suspected compartment syndrome should be diagnosed using a combination of clinical review and CPM. 73% had CPM devices available representing an increase of 27% compared with previously published UK data. 43% improvised a device using a standard CVP/Arterial-line, transducer and monitor. Marked variation in threshold pressure was noted with the majority recommending perfusion pressure (PP) of diastolic blood pressure (DBP)--intracompartmental pressure (ICP) < 30 mmHg for intervention. We have found no published evidence to suggest that CPM in itself is harmful. Although a marked variation in intervention threshold exists in the literature, we would support a perfusion pressure of < 30 mmHg as being a safe, familiar and conservative intervention threshold, particularly when used in conjunction with clinical assessment.