An overview of Crush syndrome
Year 2024,
Volume: 4 Issue: 1, 10 - 17, 30.06.2024
Beyza Civelek
,
Bengisu Arslan
,
Sude Kurt
,
Türkan Melis Sankur
,
Elif Zeynep Kasapoğlu
,
Elif Ceren Tekdoğan
,
İlayda Elbaş
,
Tuba Çandar
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
Beyza Civelek
,
Bengisu Arslan
,
Sude Kurt
,
Türkan Melis Sankur
,
Elif Zeynep Kasapoğlu
,
Elif Ceren Tekdoğan
,
İlayda Elbaş
,
Tuba Çandar
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.