Park Chanyang, Kim Hyuckgoo
Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Saudi J Anaesth. 2020 Apr-Jun;14(2):221-223. doi: 10.4103/sja.SJA_565_19. Epub 2020 Mar 5.
Extravasation is an inadvertent injection or leakage of fluid and drugs in the extravascular or subcutaneous space. The extravasation by massive transfused blood results in the elevation of intra-compartmental pressures. Severely increased pressure may lead to acute compartment syndrome (ACS). A 50-year-old man underwent craniectomy for traumatic subdural hemorrhage of the brain. During intraoperative periods, the blood components were transfused by rapid transfusion device and manual pressurized pumping through the central and peripheral lines because of hemorrhagic hypovolemic shock. Approximately 30 minutes after transfusion, we found a hardened right low leg that was obscured by the surgical drape. Immediately, fasciotomy was performed to release all four compartments. The early recognition and treatment of ACS were important factors contributing to anatomical structure salvage and preservation of function. Anesthesia providers should check the site of the insertion of the intravenous catheter, especially while pressurized massive transfusion via the peripheral intravenous catheter.
外渗是指液体和药物意外注入血管外或皮下间隙。大量输血引起的外渗会导致隔室内压力升高。压力严重升高可能导致急性筋膜室综合征（ACS）。一名50岁男性因外伤性脑硬膜下出血接受了颅骨切除术。术中，由于出血性低血容量休克，通过快速输血装置以及经中心静脉和外周静脉线路手动加压泵注进行血液成分输血。输血后约30分钟，我们发现右小腿变硬，手术单遮挡了该部位。立即进行筋膜切开术以松解所有四个筋膜室。急性筋膜室综合征的早期识别和治疗是有助于挽救解剖结构和保留功能的重要因素。麻醉人员应检查静脉导管的插入部位，尤其是在通过外周静脉导管进行加压大量输血时。
