Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.2.1.36 (hyaluronidase)
 4,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The treatment of compartment syndromes in which elevation of intracompartmental pressure occurs is by surgical fasciotomy. This is a relatively simple procedure but may be associated with complications. This study aimed at developing an alternative method to decompress a compartment by use of the enzyme hyaluronidase. Autologous plasma was infused into the anterolateral leg compartments of six dogs to simulate compartment syndromes of 80 mmHg. Pressure decay after pressurization was recorded. The compartment pressures were then again raised to 80 mmHg by subfascial injections of 1500 units hyaluronidase in 2 ml saline injected into one compartment and 2 ml saline only into the control side. Pressure decay was again recorded. On the experimental side, a significantly faster decay rate occurred after hyaluronidase injection than after initial pressurization; 8.0 +/- 1.3 (S.E.M.) versus 3.4 +/- 0.4 (S.E.M.) mmHg/min (p less than .01). Pressure decay after hyaluronidase injection was significantly faster than after the same volume injection on the control side, over both a four-minute period (8.0 +/- 1.3 [S.E.M.] versus 4.1 +/- 0.6 [S.E.M.] mmHg/min [p less than .03]) and a 25-minute period (2.1 +/- 0.3 [S.E.M.] versus 1.3 +/- 0.1 [S.E.M.] mmHg/min [p less than .03]). Hyaluronidase removes hyaluronic acid molecules from the leg compartment fascia and, by facilitating fluid flow from the compartment, causes decompression. Hyaluronidase may then have a place in the prophylaxis and treatment of compartment syndrome, thus avoiding anesthesia and surgery.
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PMID:Decompression of an experimental compartment syndrome in dogs with hyaluronidase. 401 43

A 74-year-old woman underwent posterior lumbar decompressive fusion at L4-5 for treating spondylolisthesis, with the patient under general anesthesia and she was in the prone position. Following attempts to transfuse blood using a pressurized bag, the intravenous infusion site of the left hand along with the noninvasive blood pressure cuff was changed. Swelling and several bullae on the left forearm and hand were visible. Removal of intravenous catheter, hyaluronidase injection, wet dressing were subsequently performed. In postanesthesia recovery unit, the patient did not complain of pain, and the radial pulse and oxygen saturation of the left appeared normal. Three days after the incident, the edema on the patient's forearm and hand subsided, and the patient was discharged without any complications two weeks afterwards. Impending compartment syndrome should be given close attention, and particularly when performing pressurized infusion in patients who are unable to express pain because they are under general anesthesia.
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PMID:Impending compartment syndrome of the forearm and hand after a pressurized infusion in a patient under general anesthesia -A case report-. 2135 85

In minor cases, contrast extravasation may cause pain, swelling, and localized erythema. However, in more severe cases, extensive tissue and skin necrosis, ulceration, and compartment syndrome may occur, often necessitating a surgical consultation. Hyaluronidase has been used successfully in the management of extravasated contrast media in several reports. In addition, recombinant human hyaluronidase is approved for use as an adjunct in subcutaneous urography for improving resorption of radiopaque agents. In this case, a 57-year-old white female admitted for a chronic obstructive pulmonary disease exacerbation with pneumonitis and hypoxic respiratory failure experienced contrast extravasation during a computed tomographic scan of her chest. Approximately 100 mL of iodinated contrast extravasated into the right antecubital fossa, infiltrating approximately the distal two-thirds of the upper arm. Five 150-U vials of recombinant human hyaluronidase were injected in 150-U aliquots in a circle around the extravasation site using a 27-gauge needle 1 hour after the extravasation occurred. In a follow-up 4 hours later, marked improvement was observed. Sixteen hours after hyaluronidase treatment, the tissue had reverted to a near-normal state with no pain, erythema, swelling, or tenderness noted. Hyaluronidase successfully treated this extravasation of a large volume of iodinated contrast and appears to be a reasonable treatment option for more extensive subcutaneous contrast media extravasations.
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PMID:Extravasation of contrast media managed with recombinant human hyaluronidase. 2263 26