Development of Compartment Syndrome after Radial Artery Puncture in a Patient with Acute Hypoxemic Respiratory Failure due to COVID-19

Table 2

Summary of case reports of forearm compartment syndrome after arterial puncture.

Patient characteristics	Anticoagulation or bleeding risk factors	Procedure	Diagnosis	Treatment	Outcome	Reference
29-year-old woman with pulmonary embolism	Coumadin	Unsuccessful attempt at ABG sampling from left radial artery	Left forearm compartment syndrome	Fasciotomy of the volar compartment of the left forearm; skin grafting	Full recovery of motor function; persistent small sensory deficit.	Halpern, 1978 [4]
54-year-old woman with pulmonary embolism	Thrombolysis with tenecteplase	Blood gas sampling from right radial artery	Right forearm compartment syndrome	Emergent fasciotomy; skin grafting	“Uneventful recovery”	Bisarya, 2013 [5]
30-year-old woman with end-stage renal disease due to Goodpasture’s syndrome	Uremia	Blood gas sampling from left brachial artery	Left volar forearm compartment syndrome	Emergent fasciotomy; platelet transfusion for uremic platelet dysfunction	Complete recovery of sensory function 2 days after surgery	Safran, 1994 [6]
16-year-old woman after a motor vehicle accident with extensive intraabdominal and intrathoracic injuries; no right upper extremity fractures	Prolonged surgery with massive intraoperative blood loss requiring massive transfusion	Preoperative right brachial arterial line placement after several needle passes	Right forearm and hand compartment syndrome	Monitoring of compartment pressures.; No surgical intervention performed.	Full recovery	Horlocker, 1995 [7]
52-year-old man with end-stage liver disease secondary to primary sclerosing	Severe intraoperative coagulopathy requiring massive transfusion during orthotopic liver transplantation	Right radial arterial line placement after 2 unsuccessful attempts	Right anterior forearm compartment syndrome	Fasciotomy	Full recovery	Lipton, 2018 [8]
Patient in 60s admitted with acute pulmonary embolism	Full dose anticoagulation with therapeutic low-molecular-weight heparin and then therapeutic heparin infusion	Multiple attempts at ABG sampling from the radial artery	Right forearm compartment syndrome	Emergent fasciotomy; extensive debridement of necrotic muscle; required a total of 6 surgeries and skin grafting	Poor outcome with poor wrist and finger flexion; impaired sensation in the median and ulnar nerve distributions in the hand	Elmorsy, 2017 [9]
ICU patient admitted with pulmonary embolism, age not reported	Full anticoagulation and thrombolytics	Multiple attempts to obtain blood gas sample from right radial artery	Right forearm compartment syndrome	Emergent fasciotomy; multiple washout and debridement surgeries	Only partial improvement of motor and sensory deficits	Elmorsy, 2017 [9]
ICU patient who developed DVT and PE during admission, age not reported	Therapeutic heparin infusion	Multiple attempts to obtain blood gas sample from right radial artery	Right forearm compartment syndrome	No surgical intervention performed due to overall poor prognosis of patient.	Death 7 days later	Elmorsy, 2017 [9]
22-year-old man admitted to ICU after severe head injury	None	Repeated arterial punctures for blood gas sampling	Large false aneurysm of the distal right radial artery with subsequent forearm compartment syndrome	Resection of the false aneurysm	Not reported	Matsagas, 2003 [10]
76-year-old man with acute coronary syndrome	Therapeutic heparin infusion after cardiac stent placement	Accidental placement of a 21-gauge intravenous cannula into the right brachial artery which was removed without immediate complications	Compartment syndrome of the flexor forearm compartment developed 2 days after accidental arterial cannulation, while on heparin infusion	Fasciotomy, repair of brachial artery tear, skin grafting	Full recovery	Shabat, 2002 [11]
4 patients (3 women, 1 man), age range 60–75	Full anticoagulation	Transradial left heart catheterization	Forearm compartment syndrome; rupture of the radial artery at the puncture site (3 patients); rupture of both brachial and radial artery (one patient)	Early surgical decompressive fasciotomy; repair of arterial ruptures	Full recovery	Lee, 2020 [12]
68-year-old man with acute coronary syndrome	Heparin infusion.; Vasospasm induced by the radial arterial sheath	Cardiac catheterization via the right radial artery	Compartment syndrome caused by vasospasm	Fasciotomy; intraoperative finding of edema without any evidence of bleeding or hematoma or injury to the artery	Full recovery	Araki, 2010 [13]