Crush syndrome is caused by long-term compression or massive contusion of soft tissues (mainly muscles) → their ischemia and damage occurs.
After the pressure is removed, myoglobin, acid metabolites and potassium are released from the damaged tissues ; fluid ( plasma ) transudates into the damaged tissue , causing edema . Loss of plasma intravascularly leads to the development of hypovolemic shock, shock kidney and acute renal insufficiency.
Signs[edit | edit source]
- myoglobinuria, hypovolemia → acute renal insufficiency to acute renal failure
- hyperkalemia → risk of arrhythmia
- transudation of fluid into tissues with subsequent swelling
- local skin damage
Stages of crush syndrome[edit | edit source]
Stages of crush syndrome
- acute (1–2 days) – hypovolemic shock, hyperkalemia, limb edema (vessel and nerve compression), skin damage
- subacute (2 weeks) – acute renal failure (oliguria to anuria, hyperazotemia, hyperkalemia), demarcation of necrosis
- late – recovery of kidney functions (polyuria, hyposthenuria)
Treatment[edit | edit source]
- pain relief
- infusion of alkalizing crystalloids, diuretics
- treatment of hyperkalemia (CaCl2, NaCl, glucose with insulin, hemodialysis)
- in case of severe limb injury – amputation
- in the development of compartment syndrome – decompressive fasciotomy
Crush syndrome and compartment syndrome have some symptoms in common (result of muscle ischemia), but in compartment syndrome the symptoms are mainly local , in crush syndrome they are 'general'. Total muscle damage can occur with blast syndrome - blast injury
Perthes syndrome (blue mask syndrome) – a special type of burial injury, when chest compression restricts breathing movements, and at the same time, petechiae appear on the head and under the conjunctivae
Links[edit | edit source]
Related articles[edit | edit source]
- Blast injury
- Compartment syndrome
- Compartment syndrome of the lower leg
- Hypovolemic shock
Source[edit | edit source]
- PASTOR, J. Langenbeck's medical web page [online]. [cit. 18. 1. 2010]. <https://www.freewebs.com/langenbeck/>.
References[edit | edit source]
- ZEMAN, Miroslav. Chirurgická propedeutika. 2. edition. Grada, 2000. 524 pp. ISBN 80-7169-705-2.