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An overview of Crush syndrome

Year 2024, Volume: 4 Issue: 1, 10 - 17, 30.06.2024

Abstract

Crush Syndrome is a life-threatening condition that requires rapid and effective intervention, which can lead to circulatory failure, electrolyte disorder, metabolic problems, and acute renal failure, which occurs as a result of any crushing and pressure in the body. Continuous pressure exposure in the muscles eventually leads to microvascular trauma that resulting in hypoperfusion and/or hypoxia. Following the rapid assessment of vital and general status of the patients we have to run basic laboratory tests such as; complete blood count, basic metabolic panel, liver function test, CRP (C-reactive protein) levels, ESR (sedimentation rate) levels, CPK (creatine kinase) levels, urinalysis, EKG, chest X-ray. Patients with stabilization should be treated immediately by opening vascular access and closing the fluid and electrolyte deficits. Follow-up processes should be evaluated in the intensive care unit for the first 24 hours in terms of catheter urine monitoring and electrolyte monitoring. In addition, the patient should be followed up for neurological and psychological evaluation in the future

References

  • Scapellato S, Maria S, Castorina G, Sciuto G. Crush syndrome. Minerva Chir. 2007;62:285-92.
  • Better OS. The crush syndrome revisited (1940-1990). Nephron. 1990;55:97-103.
  • Peiris D. A historical perspective on crush syndrome: the clinical application of its pathogenesis, established by the study of wartime crush injuries. J Clin Pathol. 2017;70:277-81.
  • Michaelson M. Crush injury and crush syndrome. World J Surg. 1992;16:899-903.
  • Long B, Liang SY, Gottlieb M. Crush injury and syndrome: A review for emergency clinicians. Am J Emerg Med. 2023;69:180-7.
  • Gonzalez D. Crush syndrome. Crit Care Med. 2005;33:34-41.
  • Malinoski DJ, Slater MS, Mullins RJ. Crush injury and rhabdomyolysis. Crit Care Clin. 2004;20:171-92.
  • Stanley M, Chippa V, Aeddula NR, Quintanilla Rodriguez BS, Adigun R. Rhabdomyolysis. In: StatPearls. Treasure Island (FL), Stat Pearls Publishing, 2024.
  • Smith J, Greaves I. Crush injury and crush syndrome: a review. J Trauma. 2003;54:226-30.
  • Derici U, Ozkaya O, Arinsoy T, Erbas D, Sindel Ş, Bali M et al. Increased plasma nitrate levels in patients with Crush syndrome in the Marmara earthquake. Clinica Chimica Acta. 2002;322(1–2).
  • Atmis B, Bayazit AK, Cagli Piskin C, Saribas E, Piskin FC, Bilen S et al. Factors predicting kidney replacement therapy in pediatric earthquake victims with crush syndrome in the first week following rescue. Eur J Pediatr. 2023;182:5591-8.
  • Aygin D, Atasoy İ. Crush sendromu tedavi ve bakımı. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2008;11:93-100.
  • Better OS, Abassi Z, Rubinstein I, Marom S, Winaver Y, Silberman M. The mechanism of muscle injury in the crush syndrome: ischemic versus pressure-stretch myopathy. Miner Electrolyte Metab. 1990;16:181-4.
  • Atef-Zafarmand A, Fadem S. Disaster nephrology: medical perspective. Adv Ren Replace Ther. 2003;10:104-16.
  • Zvezdina MV, Bialik IF, Shimanko II. Features of the treatment of suppurative complications of limb injuries in prolonged Crush syndrome. Anesteziol Reanimatol. 1995;4:17-9.
  • Fedorov VD, Borisova OK, Kuleshov SE, Pavlova MV, Pal'mina SI, Kosaia VA et al. [Characteristics of wound infection in long-term Crush syndrome]. Khirurgiia (Mosk). 1990;6:33-8.

Crush sendromuna genel bir bakış

Year 2024, Volume: 4 Issue: 1, 10 - 17, 30.06.2024

Abstract

Crush Sendromu (Ezilme Sendromu) vücutta herhangi bir ezilme ve baskı sonucu ortaya çıkan; zamanla dolaşım yetmezliği, elektrolit bozukluğu, metabolik sorunlar, akut böbrek yetmezliğe kadar giden bir tabloya yol açabilecek hızlı ve etkin müdahale gerektiren yaşamı tehdit eden bir durumdur. Kaslarda gelişen sürekli basınç maruziyeti bir süre sonra mikrovasküler travma, sonuçta da hipoperfüzyona ve/veya hipoksiye yol açar. Hastaların hızlıca vital ve genel durum değerlendirmelerinin ardından tam kan sayımı, temel metabolik panel, karaciğer fonksiyon testi, CRP (C-reaktif protein) düzeyleri, ESR (sedimentasyon hızı) düzeyleri, CPK (kreatin kinaz) düzeyleri, idrar tahlili, EKG, akciğer grafisi gibi temel laboratuvar tetkikleri yapılmalıdır. Stabilizasyonu sağlanan hastalara hemen damar yolu açılıp sıvı ve elektrolit açıkları kapatılarak tedaviye başlanmalıdır. Takip süreçleri ilk 24 saat yoğun bakım ünitesinde sondayla idrar ve elektrolit takipleri açısından değerlendirilmelidir. Ayrıca ilerleyen dönemlerde nörolojik ve ruhsal değerlendirme açılarından hasta takip edilmelidir.

References

  • Scapellato S, Maria S, Castorina G, Sciuto G. Crush syndrome. Minerva Chir. 2007;62:285-92.
  • Better OS. The crush syndrome revisited (1940-1990). Nephron. 1990;55:97-103.
  • Peiris D. A historical perspective on crush syndrome: the clinical application of its pathogenesis, established by the study of wartime crush injuries. J Clin Pathol. 2017;70:277-81.
  • Michaelson M. Crush injury and crush syndrome. World J Surg. 1992;16:899-903.
  • Long B, Liang SY, Gottlieb M. Crush injury and syndrome: A review for emergency clinicians. Am J Emerg Med. 2023;69:180-7.
  • Gonzalez D. Crush syndrome. Crit Care Med. 2005;33:34-41.
  • Malinoski DJ, Slater MS, Mullins RJ. Crush injury and rhabdomyolysis. Crit Care Clin. 2004;20:171-92.
  • Stanley M, Chippa V, Aeddula NR, Quintanilla Rodriguez BS, Adigun R. Rhabdomyolysis. In: StatPearls. Treasure Island (FL), Stat Pearls Publishing, 2024.
  • Smith J, Greaves I. Crush injury and crush syndrome: a review. J Trauma. 2003;54:226-30.
  • Derici U, Ozkaya O, Arinsoy T, Erbas D, Sindel Ş, Bali M et al. Increased plasma nitrate levels in patients with Crush syndrome in the Marmara earthquake. Clinica Chimica Acta. 2002;322(1–2).
  • Atmis B, Bayazit AK, Cagli Piskin C, Saribas E, Piskin FC, Bilen S et al. Factors predicting kidney replacement therapy in pediatric earthquake victims with crush syndrome in the first week following rescue. Eur J Pediatr. 2023;182:5591-8.
  • Aygin D, Atasoy İ. Crush sendromu tedavi ve bakımı. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2008;11:93-100.
  • Better OS, Abassi Z, Rubinstein I, Marom S, Winaver Y, Silberman M. The mechanism of muscle injury in the crush syndrome: ischemic versus pressure-stretch myopathy. Miner Electrolyte Metab. 1990;16:181-4.
  • Atef-Zafarmand A, Fadem S. Disaster nephrology: medical perspective. Adv Ren Replace Ther. 2003;10:104-16.
  • Zvezdina MV, Bialik IF, Shimanko II. Features of the treatment of suppurative complications of limb injuries in prolonged Crush syndrome. Anesteziol Reanimatol. 1995;4:17-9.
  • Fedorov VD, Borisova OK, Kuleshov SE, Pavlova MV, Pal'mina SI, Kosaia VA et al. [Characteristics of wound infection in long-term Crush syndrome]. Khirurgiia (Mosk). 1990;6:33-8.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences (Other)
Journal Section Review
Authors

Beyza Civelek 0009-0006-4849-4750

Bengisu Arslan 0009-0006-2776-7991

Sude Kurt 0009-0008-8762-0507

Türkan Melis Sankur 0009-0003-9305-7208

Elif Zeynep Kasapoğlu 0009-0005-3741-7699

Elif Ceren Tekdoğan 0009-0009-6080-9227

İlayda Elbaş 0009-0008-3027-1502

Tuba Çandar 0000-0002-3922-5915

Publication Date June 30, 2024
Submission Date April 4, 2024
Acceptance Date May 2, 2024
Published in Issue Year 2024 Volume: 4 Issue: 1

Cite

AMA Civelek B, Arslan B, Kurt S, Sankur TM, Kasapoğlu EZ, Tekdoğan EC, Elbaş İ, Çandar T. Crush sendromuna genel bir bakış. Çukurova Tıp Öğrenci Derg. June 2024;4(1):10-17.