RISKS AND INTERVENTIONS IN COMPARTMENT SYNDROME IN CHILDREN WITH CRITICAL POLYTRAUMA

Abstract

Acute Compartment Syndrome (ACS) is a frequent complication in polytraumatized patients, characterized by increased intracompartmental pressure in affected organs or limbs. When failed to identify and treat early, it may progress to ischemia, tissue necrosis, muscle impairment, limb amputations and even death. This condition is more prevalent among patients admitted to Intensive Care Units (ICUs). This study aimed to review the clinical manifestations of ACS in children, its main predisposing factors, the therapeutic strategies used and their effectiveness, with an emphasis on critical polytrauma cases. An integrative literature review was conducted using SciELO, LILACS, and PubMed databases. For material selection, the recency and thematic relevance of publications was considered, including articles from the last 5 to 10 years addressing ACS in the context of pediatric polytrauma. The findings indicated that the main causative agents include high-energy trauma, fractures, extensive burns and envenomation by poisonous animals. In children, early diagnosis is essential, but may be hindered by limitations in communication and atypical clinical presentation. Fasciotomy is considered the most effective treatment, with outcomes directly related to the timing of the intervention; however, complications such as infections, nerve injuries, and tissue damage are common. It's concluded that the management of pediatric ACS requires a multidisciplinary approach, emphasizing early detection of clinical signs and a prompt response from a well-trained healthcare team. The implementation of specific protocols and the use of biomarkers may significantly contribute to timely diagnosis and improved outcomes, minimizing the risk of permanent sequelae and reducing mortality.