title: Secondary extremity compartment syndrome.
abstract: BACKGROUND
  Abdominal compartment syndrome has been reported to occur after fluid resuscitation in injured patients, even in the absence of intra-abdominal injuries. This report describes a set of patients who developed the secondary extremity compartment syndrome (SECS) in uninjured extremities after resuscitation for other injuries.
  
  
  METHODS
  This study was a retrospective chart review of all trauma patients developing SECS at a Level I trauma center. Data are mean +/- SD.
  
  
  RESULTS
  From 1996 to 2001, 10 patients (8 men, age 31 +/- 13 years, Injury Severity Score of 29 +/- 17, and 3 with penetrating trauma) from a series of 11,996 trauma admissions developed SECS after resuscitation for other injuries. The mean number of extremities developing the SECS per patient was 3.1. This included compartment syndromes in 10 upper extremities and in 12 lower extremities that did not have any apparent injuries (i.e., contusions, fractures, or vascular injuries). After evaluation by the trauma team, abdominal silos were needed in 7 of the 10 patients also, and the mortality in patients with the SECS was 70%.
  
  
  CONCLUSIONS
  SECS is a rare complication of the postresuscitation systemic inflammatory response syndrome, is associated with significant morbidity, and may be a marker for mortality. SECS should be ruled out by measurement of compartment pressures in uninjured and injured extremities in patients with severe diffuse edema after resuscitation for injury.
authors.affiliation: Department of Surgery, Grady Memorial Hospital, Atlanta, GA 30303, USA.
authors.forename: Lorraine N
authors.initials: LN
authors.lastname: Tremblay
authors.forename: David V
authors.initials: DV
authors.lastname: Feliciano
authors.forename: Grace S
authors.initials: GS
authors.lastname: Rozycki
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005121:Extremities; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000628:therapy; D012151:Resuscitation / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome