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During the current pandemic of COVID-19, a myriad of manifestations and complications has emerged and are being reported on. We are discovering patients with COVID-19 are at increased risk of acute cardiac injury, arrythmias, thromboembolic complications (pulmonary embolism and acute stroke), and secondary infection to name a few. I describe a novel case of COVID-19 in a previously healthy 33-year-old female who presented for altered mental status and proptosis. She was ultimately diagnosed with mucormycosis and orbital compartment syndrome, in addition to COVID-19. Early identification of these high morbidity conditions is key to allow for optimal treatment and improved outcomes.

Background Acute compartment syndrome (ACS) is a critical condition resulting from increased intra-compartmental pressure, causing tissue ischemia and necrosis. ACS following cardiovascular surgery is rare but catastrophic. Postoperative sedation and analgesia often obscure classic symptoms, delaying diagnosis. This underscores the importance of vigilance and early detection, particularly in high-risk scenarios such as prolonged extracorporeal circulation and femoral artery cannulation. Enhanced monitoring, including tissue oxygen saturation and transcutaneous oxygen pressure, may facilitate timely diagnosis. Case summary We report a 56-year-old male who developed ACS after valve replacement surgery involving femoral artery cannulation for cardiopulmonary bypass. Approximately 12 h postoperatively, the patient exhibited severe lower limb swelling, mottling, and diminished dorsalis pedis pulse. Laboratory findings revealed elevated myoglobin and creatine kinase levels. Diagnosis was confirmed via clinical and ultrasound evaluation, prompting emergent fasciotomy. Postoperative management included wound care, renal replacement therapy, and skin flap reconstruction. At 6 months follow-up, the patient achieved complete functional recovery of the affected limb. Conclusion ACS is a rare but severe complication of cardiovascular surgery. This case highlights the necessity for heightened vigilance, early recognition, and timely intervention to mitigate adverse outcomes. Further studies are needed to validate and establish standardized monitoring protocols and management strategies, including early use of distal perfusion techniques, to improve surgical safety and patient outcomes.

A compartment syndrome is defined as an increase in the compartmental pressure to such an extent that the viability of the tissues and organs within the compartment are threatened. The term describes a syndrome and not a disease, and as such there are many diseases and underlying pathophysiological processes that may lead to such a scenario. The aim of this review is to give a state-of-the-art overview on the current knowledge on different compartment syndromes and how they may interact. Suggested definitions are included. There are four major compartments in the human body: the head, chest, abdomen, and the extremities. Initially, the term multicompartment syndrome was suggested when more than one compartment was affected. But this led to confusion as the term multi- or multiple compartment syndromes is mostly used in relation to multiple limb trauma leading to compartment syndrome requiring fasciotomy. Only recently was the term 'polycompartment syndrome' coined to describe a condition where two or more anatomical compartments have elevated pressures. When more than one compartment is affected, an exponential detrimental effect on end-organ function to both immediate and distant organs can occur. Within each compartment, the disease leading towards a compartment syndrome can be primary or secondary. The compliance of each compartment is the key to determining the transmission of a given compartmental pressure from one compartment to another. The intra-abdominal pressure helps to explain the severe pathophysiological condition occurring in patients with cardiorenal, hepatopulmonary and hepatorenal syndromes. Initial treatment of a compartment syndrome should be focused on the primary compartment and is based on three principles: lowering of compartmental pressure, supporting organ perfusion, and optimisation and prevention of specific adverse events. Clinicians need to be aware of the existence of the polycompartment syndrome and the interactions of increased compartmental pressures between compartments.

Cargo compartments are important components of conventional transport category aircraft, serving both passenger and freight operations. Following a fire-related accident on a South African Airways flight, the FAA introduced Amendment 25-142 to revise the definition of Class B compartments and establish Class F compartments, thereby enhancing fire protection standards. This paper provides a detailed definition of Class F compartments, analyzes compliance methods for their key design elements, and proposes fire protection design recommendations. A reference compliance approach, validated through experimental data, is presented. The experimental results demonstrate the effectiveness of the proposed methodology in achieving fire suppression and compartment isolation requirements.

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. In the absence of consensus definitions and treatment guidelines the diagnosis and management of IAH and ACS remains variable from institution to institution. An international consensus group of multidisciplinary critical care specialists convened at the second World Congress on Abdominal Compartment Syndrome to develop practice guidelines for the diagnosis, management, and prevention of IAH and ACS. Prior to the conference the authors developed a blueprint for consensus definitions and treatment guidelines which were refined both during and after the conference. The present article is the second installment of the final report from the 2004 International ACS Consensus Definitions Conference and is endorsed by the World Society of the Abdominal Compartment Syndrome. The prevalence and etiological factors for IAH and ACS are reviewed. Evidence-based medicine treatment guidelines are presented to facilitate the diagnosis and management of IAH and ACS. Recommendations to guide future studies are proposed. These definitions, guidelines, and recommendations, based upon current best evidence and expert opinion are proposed to assist clinicians in the management of IAH and ACS as well as serve as a reference for future clinical and basic science research.

The water entry process of the aircraft will affect the flotation characteristics of the aircraft, which is an important topic to ensure the safety of the aircraft. It usually requires a significant amount of time to simulate the water-entry process accurately. In the current study, the material point method is applied to solve the water-entry problem of the aircraft cabin structure, which has the potential to reduce the time cost while ensuring accuracy. The method is introduced first and is verified by comparing it with the existing results. Then, a simplified cabin structure is established, and the water-entry process is analysed, which shows the feasibility of the proposed method.

Purpose To investigate distributions and identify possible differences in intramuscular pressure (IMP) values at 1 min post-exercise between the four muscle compartments of the lower leg, in patients with exertional leg pain with or without chronic exertional compartment syndrome (CECS). Methods A consecutive series of patients seeking orthopaedic consultation for exertional leg pain underwent IMP measurements between 2009 and 2018. The diagnosis of CECS was confirmed ( n  = 442) or ruled out ( n  = 422), based on the patient’s history, clinical examination, and IMP measurements. Results The median (range) 1 min post-exercise IMP values in affected compartments in the patients diagnosed with CECS were 33 (25–53) mmHg (deep posterior), 35 (27–54) mmHg (superficial posterior), 40 (26–106) mmHg (lateral), and 47 (24–120) mmHg (anterior). In patients with no CECS, the median (range) 1 min post-exercise IMP values in the compartments were 12 (2–28) mmHg (deep posterior), 12 (2–27) mmHg (superficial posterior), 14 (2–26) mmHg (lateral), and 18 (4–34) mmHg (anterior). The IMP was significantly lower in the lateral and both posterior compartments than in the anterior compartment in both patients diagnosed with CECS and patients without CECS. Conclusion The study demonstrates significantly lower IMP values in the posterior and lateral compartments compared to the anterior compartments. These findings suggest a lowering of the IMP 1 min post-exercise cut-off value for diagnosing CECS in the lateral and both posterior compartments, which may lead to improved treatment of patients with suspected CECS in the lower leg. Level of evidence Level II.

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .

Primary disasters may result in mass casualty events with serious injuries, including crush injury and crush syndrome. This narrative review provides a focused overview of crush injury and crush syndrome for emergency clinicians. Millions of people worldwide annually face natural or human-made disasters, which may lead to mass casualty events and severe medical issues including crush injury and syndrome. Crush injury is due to direct physical trauma and compression of the human body, most commonly involving the lower extremities. It may result in asphyxia, severe orthopedic injury, compartment syndrome, hypotension, and organ injury (including acute kidney injury). Crush syndrome is the systemic manifestation of severe, traumatic muscle injury. Emergency clinicians are at the forefront of the evaluation and treatment of these patients. Care at the incident scene is essential and focuses on treating life-threatening injuries, extrication, triage, fluid resuscitation, and transport. Care at the healthcare facility includes initial stabilization and trauma evaluation as well as treatment of any complication (e.g., compartment syndrome, hyperkalemia, rhabdomyolysis, acute kidney injury). Crush injury and crush syndrome are common in natural and human-made disasters. Emergency clinicians must understand the pathophysiology, evaluation, and management of these conditions to optimize patient care.

As a core component of the cabin interior equipment and furnishing system, cabin class dividers hold significant importance in the overall design of the aircraft cabin. Based on three core dimensions—design inputs, design contents, and airworthiness verification—this study systematically elaborates on the design process and methodology system for civil aircraft cabin class dividers, aiming to provide theoretical foundations and technical references for related engineering practices.