Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model
Abstract Acute Compartment Syndrome (ACS) is one of the most devastating orthopedic conditions, affecting any of the body’s many compartments, which, if sufficiently severe, may result in disability and amputation. Currently, intra-compartmental pressure measurements serve as the gold standard for d...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-45209-w |
| _version_ | 1797452731269513216 |
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| author | Aron Lechtig Philip Hanna Janice A. Nagy John Wixted Ara Nazarian Seward B. Rutkove |
| author_facet | Aron Lechtig Philip Hanna Janice A. Nagy John Wixted Ara Nazarian Seward B. Rutkove |
| author_sort | Aron Lechtig |
| collection | DOAJ |
| description | Abstract Acute Compartment Syndrome (ACS) is one of the most devastating orthopedic conditions, affecting any of the body’s many compartments, which, if sufficiently severe, may result in disability and amputation. Currently, intra-compartmental pressure measurements serve as the gold standard for diagnosing ACS. Diagnosing limbs at risk for ACS before irreversible damage to muscle and nerve is critical. Standard approaches for diagnosing impending compartment syndrome include clinical evaluation of the limb, such as assessment for “tightness” of the overlying skin, reduced pulses distally, and degree of pain, none of which are specific or sensitive. We have proposed a novel method to detect ACS via electrical impedance myography (EIM), where a weak, high-frequency alternating current is passed between one pair of electrodes through a region of tissue, and the resulting surface voltages are measured via a second pair. We evaluated the ability of EIM to detect early muscle ischemia in an established murine model of compression-induced muscle injury, where we collected resistance, reactance, and their dimensionless product, defined as Relative Injury Index (RII) during the study. Our model generated reproducible hypoxia, confirmed by Hypoxyprobe™ staining of endothelial regions within the muscle. Under conditions of ischemia, we demonstrated a reproducible, stable, and significant escalation in resistance, reactance, and RII values, compared to uninjured control limbs. These data make a reasonable argument for additional investigations into using EIM for the early recognition of muscle hypoperfusion and ischemia. However, these findings must be considered preliminary steps, requiring further pre-clinical and clinical validation. |
| first_indexed | 2024-03-09T15:12:54Z |
| format | Article |
| id | doaj.art-92fc6cc226484f7194a5d993185788d5 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:12:54Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-92fc6cc226484f7194a5d993185788d52023-11-26T13:16:28ZengNature PortfolioScientific Reports2045-23222023-10-011311910.1038/s41598-023-45209-wElectrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat modelAron Lechtig0Philip Hanna1Janice A. Nagy2John Wixted3Ara Nazarian4Seward B. Rutkove5Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical SchoolMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical SchoolMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolAbstract Acute Compartment Syndrome (ACS) is one of the most devastating orthopedic conditions, affecting any of the body’s many compartments, which, if sufficiently severe, may result in disability and amputation. Currently, intra-compartmental pressure measurements serve as the gold standard for diagnosing ACS. Diagnosing limbs at risk for ACS before irreversible damage to muscle and nerve is critical. Standard approaches for diagnosing impending compartment syndrome include clinical evaluation of the limb, such as assessment for “tightness” of the overlying skin, reduced pulses distally, and degree of pain, none of which are specific or sensitive. We have proposed a novel method to detect ACS via electrical impedance myography (EIM), where a weak, high-frequency alternating current is passed between one pair of electrodes through a region of tissue, and the resulting surface voltages are measured via a second pair. We evaluated the ability of EIM to detect early muscle ischemia in an established murine model of compression-induced muscle injury, where we collected resistance, reactance, and their dimensionless product, defined as Relative Injury Index (RII) during the study. Our model generated reproducible hypoxia, confirmed by Hypoxyprobe™ staining of endothelial regions within the muscle. Under conditions of ischemia, we demonstrated a reproducible, stable, and significant escalation in resistance, reactance, and RII values, compared to uninjured control limbs. These data make a reasonable argument for additional investigations into using EIM for the early recognition of muscle hypoperfusion and ischemia. However, these findings must be considered preliminary steps, requiring further pre-clinical and clinical validation.https://doi.org/10.1038/s41598-023-45209-w |
| spellingShingle | Aron Lechtig Philip Hanna Janice A. Nagy John Wixted Ara Nazarian Seward B. Rutkove Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model Scientific Reports |
| title | Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model |
| title_full | Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model |
| title_fullStr | Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model |
| title_full_unstemmed | Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model |
| title_short | Electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome: a study in a rat model |
| title_sort | electrical impedance myography for the early detection of muscle ischemia secondary to compartment syndrome a study in a rat model |
| url | https://doi.org/10.1038/s41598-023-45209-w |
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