A patient undergoing saphenous vein harvest for a coronary artery bypass graft (CABG) procedure may develop a compartment syndrome at the harvest sites in the lower extremities.
Clinical findings:
(1) severe tenderness
(2) pain on passive stretch
(3) paresthesia
(4) limb edema
(5) foot drop
(6) decreased range of motion
Risk factors:
(1) hypothyroidism
(2) hemorrhage at the harvest site
(3) possibly severe peripheral vascular disease
The risk of complications is increased if the patient is unable to complain prior to onset of irreversible damage:
(1) coma
(2) sedation
(3) inability to communicate
(4) use of potent analgesics
Diagnosis involves:
(1) exclusion of deep vein thrombosis and other conditions
(2) documentation of elevated pressure in the affected compartment
(3) relief of symptoms after fasciotomy (if performed early)
To read more or access our algorithms and calculators, please log in or register.
