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Case Reports in Critical Care
Volume 2016 (2016), Article ID 4206397, 4 pages
http://dx.doi.org/10.1155/2016/4206397
Case Report

Compartment Syndrome as a Result of Systemic Capillary Leak Syndrome

1The Ottawa Hospital, Ottawa, ON, Canada
2Division of Critical Care, Department of Medicine, The University of Ottawa, Ottawa, ON, Canada
3School of Psychology, The University of Ottawa, Ottawa, ON, Canada
4Department of Anesthesiology, The University of Ottawa, Ottawa, ON, Canada
5Department of Emergency Medicine, The University of Ottawa, Ottawa, ON, Canada

Received 11 May 2016; Accepted 3 August 2016

Academic Editor: Martin Albert

Copyright © 2016 Kwadwo Kyeremanteng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS) with a rare complication of compartment syndrome. Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb) of 220 g/L), hypotension, acute renal failure, and bilateral calf pain. Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria. Ongoing hemodynamic (Norepinephrine and Milrinone infusion) and respiratory (ventilator) support in the ICU was provided until resolution of intravascular fluid extravasation. Conclusions. SCLS is an extremely rare disorder characterized by unexplained episodic capillary hyperpermeability, which causes shift of volume and protein from the intravascular space to the interstitial space. Patients present with significant hypotension, hemoconcentration, hypovolemia, and oliguria. Severe edema results from leakage of fluid and proteins into tissue. The most important part of treatment is maintaining stable hemodynamics, ruling out other causes of shock and diligent monitoring for complications. Awareness of the clinical syndrome with the rare complication of compartment syndrome may help guide investigations and diagnoses of these critically ill patients.