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Near-infrared Spectroscopy Monitoring for Compartment Syndrome

Cole, Ashley L. MPH*; Smith, Emily K. MPH; Austin, Ashley V. BS; Freedman, Brett A. MD§; Shuler, Michael S. MD

doi: 10.1097/BTO.0b013e31824881f6

The basis of near-infrared spectroscopy (NIRS) is founded on light reflection and absorption through tissue and specific molecular chromophores. By using multiple wavelengths of light, chosen to leverage the specific light absorption properties of oxyhemoglobin and deoxyhemoglobin, it is possible to estimate relative concentrations of these 2 molecules in tissue. Compartment syndrome occurs when the pressure within a closed fascial space precludes delivery of oxygen to the affected extremity. Thus, NIRS presents a unique opportunity for noninvasive monitoring of muscle oxygenation saturation. This article presents an overview of NIRS technology and its evolution over the past 2 decades, a review of the current literature investigating the use of NIRS in both acute and chronic exertional compartment syndrome, and guidance for anatomic sensor placement.

*J & M Shuler

Athens Orthopedic Clinic

Georgia Health Sciences University, Athens, GA

§Landstuhl Regional Medical Center, Landstuhl, Germany

Funding: This research is funded in part by grant support from the US Department of Defense.

Disclosures: M.S.S., has intellectual property and a licensing agreement for those patents for the use of NIRS in the setting of ACS with Nonin Medical. There are no other conflicts of interest for the remaining authors.

Address correspondence and reprint requests to Michael S. Shuler, MD, 530 West Cloverhurst Avenue, Athens, GA 30606. E-mail:

Received December 13, 2011

Accepted December 27, 2011

© 2012 Lippincott Williams & Wilkins, Inc.