With other areas of medicine, such as oxygen and blood pressure monitoring transitioning to more digital methods of gathering data, there’s an opportunity for others to follow the same path. In this article, we’ll examine the opportunity as it relates to intracompartmental pressure.
Intracompartmental pressure is used in the diagnosis of Acute Compartment Syndrome (ACS), a progressive, hard-to-diagnose medical emergency that can lead to poor patient outcomes, including muscle paralysis and amputation. ACS can develop after high-energy trauma, fractures, or vascular injuries, which result in swelling, ischemia, and inflammation of the affected area.
An acute compartment syndrome diagnosis is most frequently based on the clinical presentation of a series of signs, commonly referred to as the “6 P’s”. The most common clinical signs of developing ACS are pain-related: pain out of proportion and pain on passive stretching. Although there is no clear definition of when ACS begins, it is possible to quantify intramuscular pressure by direct measurement, providing a more objective proxy for healthcare professionals.
Currently, the majority of devices on the market that measure intracompartmental pressure are single-point and fluid-based, meaning they capture pressure at one singular moment through the use of a slit catheter and fluid to determine pressure.
A surgical fasciotomy is the only effective treatment for ACS, offering an immediate decrease in compartment pressure by increasing the volume of the affected muscle through the release of the skin and muscle fascia. The outcome of ACS is directly related to the time elapsed between diagnosis and definitive treatment. ACS is a progressive phenomenon that, if untreated for only a few hours, can lead to tissue necrosis, irreversible pain, paralysis, sensory deficits, long-term disability, or even death.
Since time to diagnosis is a crucial aspect in the evolution of compartment syndrome, utilizing sensor technology to continuously monitor intracompartmental pressure and view pressure trends could provide an advantage to those in the fields of orthopedic surgery and trauma.
The microelectricalmechanical system (MEMS) is one option that can help surgeons move away from a fluid-based monitor to a more digital solution. MEMS is a small machine that uses electrical, mechanical, and wireless communication components to gather and transmit data. MEMS sensors are a minimally invasive way to gather continuous pressure measurements, making them a viable solution for aiding in the diagnosis of ACS.
MEMS technology has been used by the Defense Advanced Research Agency (DARPA) due to its size, reliability, and high level of performance. The small size of MEMS sensors allows them to be embedded in tight spaces, such as various compartments within the human body. They don’t require a lot of battery power and, thus, can last for a long time. They also are highly accurate and can be designed to capture various physical or environmental characteristics, including pressure, temperature, acceleration, vibration, radiation, and magnetic fields.
It has been proven that MEMS sensors can be used to continuously monitor intracompartmental pressure for up to 18 hours. Using MEMS sensors to continuously monitor intracompartmental pressure allows physicians to view more than a single point of data at a time, and, instead, view pressure trends. Since intracompartmental pressure can increase or decrease over the course of a few hours, having this data available can serve as an aid to a compartment syndrome diagnosis.
Technological advancements have advanced the science in many other areas of monitoring. By using MEMS technology to measure intracompartmental pressure, physicians can have a more comprehensive understanding of pressure trends instead of using data from a single point in time to guide their decision on whether or not to perform a fasciotomy. This full-picture view from the use of continuous pressure monitoring has the potential to lessen the time to an ACS diagnosis and to facilitate more efficient care-team handoffs.
About the Author:
Jessica Ader is a Marketing Communications Manager with MY01, Inc., a company that leverages its expertise in microsensor technology to provide innovative diagnostic solutions and to empower healthcare professionals with the ability to preempt severe medical conditions, thereby improving patient outcomes.