title: Compartment syndrome causes systemic inflammation in a rat.
abstract: OBJECTIVE
  Compartment syndrome results from increased intra-compartmental pressure (ICP) causing local tissue ischaemia and cell death, but the systemic effects are not well described. We hypothesised that compartment syndrome would have a profound effect not only on the affected limb, but also on remote organs.
  
  
  METHODS
  Using a rat model of compartment syndrome, its systemic effects on the viability of hepatocytes and on inflammation and circulation were directly visualised using intravital video microscopy.
  
  
  RESULTS
  We found that hepatocellular injury was significantly higher in the compartment syndrome group (192 PI-labelled cells/10(-1) mm(3), standard error of the mean (sem) 51) compared with controls (30 PI-labelled cells/10(-1) mm(3), sem 12, p < 0.01). The number of adherent venular white blood cells was significantly higher for the compartment syndrome group (5 leukocytes/30s/10 000 μm(2), sem 1) than controls (0.2 leukocytes/30 s/10 000 μm(2), sem 0.2, p < 0.01). Volumetric blood flow was not significantly different between the two groups, although there was an increase in the heterogeneity of perfusion.
  
  
  CONCLUSIONS
  Compartment syndrome can be accompanied by severe systemic inflammation and end organ damage. This study provides evidence of the relationship between compartment syndrome in a limb and systemic inflammation and dysfunction in a remote organ. Cite this article: Bone Joint J 2016; 98-B:1132-7.
authors.affiliation: Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road East London, Ontario, N6A 4G5, Canada.
authors.forename: A-R
authors.initials: AR
authors.lastname: Lawendy
authors.affiliation: Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road East London, Ontario, N6A 4G5, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Bihari
authors.affiliation: Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road East London, Ontario, N6A 4G5, Canada.
authors.forename: D W
authors.initials: DW
authors.lastname: Sanders
authors.affiliation: Davol, A Bard Company, Warwick, Rhode Island, USA.
authors.forename: A
authors.initials: A
authors.lastname: Badhwar
authors.affiliation: Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road East London, Ontario, N6A 4G5, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Cepinskas
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D016923:Cell Death; D003161:Compartment Syndromes / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D004195:Disease Models, Animal; D022781:Hepatocytes / Q000473:pathology; D007962:Leukocytes / Q000502:physiology; D008099:Liver / Q000098:blood supply; D008102:Liver Circulation / Q000502:physiology; D008297:Male; D008833:Microcirculation / Q000502:physiology; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: Acute compartment syndrome; Intravital video microscopy; Liver microcirculation; Remote organ injury; Systemic inflammatory response