NIRST and ICG-based Perfusion Imaging in Acute Compartment Syndrome

Near-infrared Spectroscopic Tomography (NIRST) and ICG-based Perfusion Imaging to Diagnose and Assess Muscle Viability in High Energy Trauma at Risk for Acute Compartment Syndrome: A Pilot Study

This is a prospective observational study of patients with suspected Acute Compartment Syndrome. The primary objective of this work is to determine whether intensity changes associated with the NIRST signal, reflecting oxy- and deoxy-hemaglobin and water concentrations or ICG fluorescence signal, reflecting tissue perfusion, can be associated with development of Acute Compartment Syndrome and identification of at-risk soft tissue and muscle.

Inclusion Criteria:

• Age 18 years or older

• Clinical suspicion of acute compartment syndrome based on orthopaedic provider assessment. Clinical suspicion would be based upon the presence of one or more of these findings:

  • Pain out of proportion to visible findings
  • Escalating doses of pain medication
  • Pain with passive stretch of toes and/or fingers
  • Pallor, paresthesias, pulselessness
  • Tense soft tissues
  • High energy tibia or forearm fracture

• Provision of informed consent

Exclusion Criteria:

• History of allergy to ICG and/or iodine
• Pregnant women or nursing mothers
• Any patient with an open wound for whom NIRST device cannot be applied >4cm from the open wound will be excluded from NIRST imaging.