Intensive Care Medicine

, Volume 16, Issue 5, pp 332–333 | Cite as

Capillary leakage complicated by compartment syndrome necessitating surgery

  • B. Guidet
  • B. Guerin
  • E. Maury
  • G. Offenstadt
  • P. Amstutz
Case Reports


A single episode of systemic capillary leak syndrome is reported in a HIV-positive patient. The shock had necessitated the infusion of large amounts of fluid with concomitant diffuse swelling and weight gain leading to compartment syndrome of both legs. This required surgical relief. The initial high hematocrit (62%) and low serum protein concentration (48 g/l) with normal factor V (molecular weight above 300 000) concentrations are the hallmark of capillary leak when they are associated with hypovolemic shock. It must be emphasized that fluid resuscitation may worsen the muscle damage with ultimate compartment syndrome. Therefore, it appears reasonable to monitor muscular pressure during volume expansion in patients with capillary leak syndrome, severe shock and muscular swelling.

Key words

Capillary permeability Hypovolemic shock Rhabdomyolysis Surgery 


  1. 1.
    Atkinson JP, Waldmann TA, Stein SF, Gelfand JA, Mc Donald WJ, Heck LM, Cohen EL, Kaplan AP, Franck MM (1977) Systemic capillary leak syndrome and monoclonal IgG gammapathy. Medicine (Baltimore) 56:225–239Google Scholar
  2. 2.
    Horwith M, Hagstrom JWC, Riggins RCK, Luckey EH (1967) Hypovolemic shock and edema due to increase capillary permeability. J Am Med Assoc 200:101–104Google Scholar
  3. 3.
    George C, Regnier B, Le Gall JR, Gastinne H, Carlet J, Rapin M (1978) Hypoyolaemic shock with oedema due to increased capillary permeability. Intensive Care Med 4:159–163Google Scholar
  4. 4.
    Landis EM (1946) Capillary permeability and the factors affecting the composition of capillary filtrate. Ann NY Acad Sci 46:713Google Scholar
  5. 5.
    Stapf P, Dudeffant P, Dupuich Y, Haglund P (1986) Choc hypovolérnique par augmentation de la perméabilité capillaire cyclique idiopathique. Réan Soins Intens Med Urg 2:143–145Google Scholar
  6. 6.
    Devictor D (1985) Mesure des pressions intramusculaires au cours du choc septique chez l'enfant. Réan Soins Intens Med Urg 1:27–28Google Scholar
  7. 7.
    Whitesides TE, Haney TC, Morimoto K, Harada H (1975) Tissue pressure measurements as a determinant for the need of fasciotomy. Clin Orthop 113:43–51Google Scholar
  8. 8.
    Ashton H (1975) The effect of increased tissue pressure on blood flow. Clin Orthop 113:15–25Google Scholar
  9. 9.
    Braquet P (1986) Proofs of involvement of PAF-acether in various immune disorders using BN 52021 (ginkgolide B): a powerful PAF-acether antagonist isolated from ginkgo-biloba L. Adv Prostaglandin Thromboxane Leukotriene Res 16:179–198Google Scholar
  10. 10.
    Lagrue G, Rahbar K, Behar A, Sobel A, Laurent J (1986) Choc récidivant avec gammapathie monoclonale. Traitement en phase aiguë et chronique par l'extrait de Ginkgo-biloba oral et parentéral. Presse Med 15:1554–1555Google Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • B. Guidet
    • 1
  • B. Guerin
    • 1
  • E. Maury
    • 1
  • G. Offenstadt
    • 1
  • P. Amstutz
    • 1
  1. 1.Service de Réanimation PolyvalenteHôpital Saint-AntoineParis Cedex 12France

Personalised recommendations