Crush Syndrome

Severe systemic manifestation of trauma and ischemia involving soft tissues, principally skeletal muscle, due to prolonged severe crushing. It leads to increased permeability of the cell membrane and to the release of potassium, enzymes, and myoglobin from within cells. Ischemic renal dysfunction secondary to hypotension and diminished renal perfusion results in acute tubular necrosis and uremia.

Also Known As:

Networked: 157 relevant articles (7 outcomes, 16 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Spinal Cord Injuries (Spinal Cord Injury)
2.	Malnutrition
3.	Traumatic Shock
4.	Inflammation
5.	Acute Kidney Injury (Acute Renal Failure)

Experts

1.	Fu, Ping: 4 articles (01/2015 - 07/2011)
2.	Zhang, Ling: 3 articles (01/2015 - 07/2011)
3.	Zhang, Li: 2 articles (12/2015 - 09/2013)
4.	Murata, Isamu: 2 articles (01/2015 - 06/2011)
5.	Liu, Hao: 2 articles (10/2013 - 12/2008)
6.	Guo, Dongyang: 2 articles (09/2013 - 02/2013)
7.	Wang, Li: 2 articles (09/2013 - 01/2010)
8.	Liu, Fang: 2 articles (05/2012 - 07/2011)
9.	Ping, Fu: 2 articles (08/2010 - 01/2009)
10.	Sever, Mehmet Sukru: 2 articles (01/2009 - 11/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Crush Syndrome:

1.	Creatine Kinase (Creatine Phosphokinase)IBA 04/01/2002 - "Few reports exist concerning the peak serum concentration of creatine kinase (CK) and the severity of crush syndrome, and the efficacy of fasciotomy in crush syndrome patients remains controversial. " 03/01/1997 - "Peak serum concentration of creatine kinase as well as the number of injured extremities serve to estimate the severity of crush syndrome." 01/01/1982 - "Systemic signs of crush syndrome included dark yellow or brown urine suggestive of myoglobinuria, and marked elevation of serum creatine kinase enzyme levels. " 08/01/1997 - "Immediately after the operation, the patient showed crush syndrome with high serum creatine kinase activity 140.501 U/l and acute renal failure caused by rhabdomyolysis. " 12/01/2001 - "Peak serum creatine kinase level as well as potassium, urea, uric acid, creatinine, lactic dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and calcium levels were the helpful biochemical parameters in estimating the severity of crush syndrome."
2.	Proline (L-Proline)FDA Link 07/01/2004 - "Proline-rich peptide-1 (PRP-1) isolated from neurosecretory granules of bovine neurohypophysis is a potent antineurodegenerative agent against spinal cord hemisection and crush syndrome-induced neurodegeneration of brain and spinal cord neurons. " 07/01/2001 - "Influence of hypothalamic proline-rich peptide on the level of [14C]glucose utilization during crush syndrome." 03/03/2005 - "Some of the proline-rich-polypeptides (PRPs) are shown to afford protection against spinal cord transection or crush syndrome-induced neurodegeneration in the brain. "
3.	Mannitol (Osmitrol)FDA LinkGeneric 01/01/2007 - "Nine hospitalized patients had crush syndrome, and a prophylactic mannitol-bicarbonate cocktail was started in all at admission. " 01/01/2007 - "It was deduced that rapid fluid therapy accompanied by the prophylactic administration of mannitol-bicarbonate are largely effective in preventing the development of ARF in cases with crush syndrome resulting from disasters." 01/01/2010 - "Crush injuries are important injuries in disaster situations: earthquakes, hurricanes, mining and road traffic accidents, war, collapse of buildings, etc. In this review article, there are discussed about epidemiology of crush syndrome, risk factors, pathophysiology (mechanisms of muscle cell injury, release of substances from injured muscles, other consequences of reperfusion), clinical features, differential diagnosis, investigations, complications (acute renal failure, hypovolemic shock, hyperkalemia, infection, compartment syndrome), approach to treatment (adequate rehydration, a forced mannitol-alkaline diuresis, intravenous fluids, management of hyperkalemia, wound care, hyperbaric oxygen, etc.), prognosis, the mortality rate and prevention (timely support may reduce morbidity and mortality)."
4.	Nerve Growth Factor (NGF)IBA 11/01/2002 - "In view of these proposed regenerative effects, we evaluated the efficacy of subcutaneous administration of highly purified murine NGF in a child with severe crush syndrome of the lower left limb. " 11/01/2002 - "Improving ischaemic skin revascularisation by nerve growth factor in a child with crush syndrome."
5.	Dalteparin (Dalteparin Sodium)FDA Link 06/15/2015 - "Improved angiogenesis and healing in crush syndrome by fibroblast growth factor-2-containing low-molecular-weight heparin (Fragmin)/protamine nanoparticles."
6.	PeptidesIBA 03/03/2005 - "Some of the proline-rich-polypeptides (PRPs) are shown to afford protection against spinal cord transection or crush syndrome-induced neurodegeneration in the brain. "
7.	Low-Molecular-Weight Heparin (Heparin, Low Molecular Weight)IBA 06/15/2015 - "Improved angiogenesis and healing in crush syndrome by fibroblast growth factor-2-containing low-molecular-weight heparin (Fragmin)/protamine nanoparticles."
8.	Ethylene Oxide (Oxirane)IBA 05/01/2004 - "Polyetox, a medicinal form of high-molecular-weight poly(ethylene oxide) (HMWPEO) improved peripheral blood supply, normalized the overall oxygen consumption, decreased erythrocyte aggregation, and reduced blood viscosity at low shear rate, and restored the antiturbulent properties (hydrodynamic index) of blood in the experiments on rats with crush syndrome. "
9.	MyoglobinIBA 01/01/2015 - "[Preliminary study on the pathogenic mechanism of myoglobin-induced endoplasmic reticulum stress and apoptosis in crush syndrome]." 01/01/2015 - "Myoglobin induced ERS and apoptosis may be involved in the pathogenesis of AKI in crush syndrome." 01/01/2007 - "The serum concentration of myoglobin is an indicator of the extent of injured muscule and the main cause of development of crush syndrome. " 09/01/1997 - "Therefore, the method of blood purification employed for crush syndrome should be selected for its effectiveness in treating ARF, rather than the elimination of myoglobin." 07/01/1995 - "[Myoglobin concentration in blood: a criterion in the evaluation of muscular tissue injury in patients with prolonged crush syndrome]."
10.	AntioxidantsIBA 02/01/2008 - "To study the clinical therapeutic effect of antioxidants assistant treatment of extremities crush syndrome (CS)in order to find new therapy. " 02/01/2008 - "[Treatment for crush syndrome of extremities with antioxidants]." 01/01/1993 - "[Regulatory role of antioxidants in the correction of lipid peroxidation in crush syndrome]." 06/01/1992 - "[Activity of antioxidants in serum of animals with experimental crush syndrome]."

Therapies and Procedures

1.	Renal Replacement Therapy (Therapies, Renal Replacement) 02/01/2013 - "Management of 7 earthquake crush syndrome victims with long-term continuous renal replacement therapy." 12/01/2002 - "Renal replacement therapy is of vital importance in the treatment of crush syndrome victims, who are frequently encountered after catastrophic earthquakes. " 12/01/2011 - "We analyzed the efficacy of continuous renal replacement therapy (CRRT) combined with blood transfusion for patients with crush syndrome from an earthquake. " 12/01/2011 - "Continuous renal replacement therapy and blood transfusions in treating patients with crush syndrome: 8 Case studies from the Wenchuan earthquake." 01/01/2009 - "We report a case with crush syndrome and multiple organ dysfunction syndrome (MODS) successfully treated with hybrid continuous renal replacement therapy (CRRT). "
2.	Fluid Therapy (Oral Rehydration Therapy) 12/01/2002 - "Response to delayed fluid therapy in crush syndrome." 10/01/1996 - "Fluid therapy may be an effective and easy treatment for acute renal failure due to the crush syndrome, even in very old patients." 01/01/2007 - "It was deduced that rapid fluid therapy accompanied by the prophylactic administration of mannitol-bicarbonate are largely effective in preventing the development of ARF in cases with crush syndrome resulting from disasters." 01/01/2010 - "Crush injuries are important injuries in disaster situations: earthquakes, hurricanes, mining and road traffic accidents, war, collapse of buildings, etc. In this review article, there are discussed about epidemiology of crush syndrome, risk factors, pathophysiology (mechanisms of muscle cell injury, release of substances from injured muscles, other consequences of reperfusion), clinical features, differential diagnosis, investigations, complications (acute renal failure, hypovolemic shock, hyperkalemia, infection, compartment syndrome), approach to treatment (adequate rehydration, a forced mannitol-alkaline diuresis, intravenous fluids, management of hyperkalemia, wound care, hyperbaric oxygen, etc.), prognosis, the mortality rate and prevention (timely support may reduce morbidity and mortality)."
3.	Blood Transfusion (Blood Transfusions) 12/01/2011 - "Sufficient blood transfusion and early dialysis treatment effectively improved the conditions of patients with crush syndrome." 12/01/2011 - "We analyzed the efficacy of continuous renal replacement therapy (CRRT) combined with blood transfusion for patients with crush syndrome from an earthquake. " 12/01/2011 - "Continuous renal replacement therapy and blood transfusions in treating patients with crush syndrome: 8 Case studies from the Wenchuan earthquake." 10/01/1979 - "The following measures contribute to the decrease of lethality in the crush-syndrome: 1. possibly rapid rescue measures with simultaneous infusion therapy, if technical difficulties delay them, 2. beginning of the infusions on the spot, particularly solutions of sodium bicarbonate, concentrated glucose solutions, remedies of blood substitute, but no blood transfusions, 3. transport into a hospital with possibilities of dialysis, 4. early fasciotomy or amputation, 5. early haemodialysis, 6. adequate antibiotics, 7. sufficient supply of calories and protein, perhaps infusions of amino acids."
4.	Decompression 12/05/2008 - "In the present study, experimental model of crush syndrome in albino rats was induced by, 2h of compression followed by 48 h of decompression, of femoral muscle tissue. " 06/01/2011 - "Prolonged compression of limb muscles and subsequent decompression are important in the development of crush syndrome (CS). " 10/01/2005 - "[Leukocyte-modulating and antioxidant activity of blood serum and bronchoalveolar lavage fluid in the course of the decompression period of long crush syndrome]." 11/01/2000 - "The experimental model of crush syndrome on white rats was induced by crush and decompression of femoral muscle tissue. " 01/01/1986 - "Histologically, histochemically and electron-microscopically were studied the extremity muscles of patients and experimental animals with crush syndrome and period of compression lasting 1.5 h, 6 and 9 h, as well as on day 1-23 after decompression. "
5.	Renal Dialysis (Hemodialysis) 01/01/2009 - "The symptoms of 17 patients met the criteria of crush syndrome; hemodialysis and prompt surgical intervention were given to them when necessary. " 01/01/2009 - "There are not enough data about the type of the membrane that should be used in acute intermittent hemodialysis (IHD) in patients with crush syndrome where intradialytic complication rate is high. " 10/01/2008 - "The removal of necrotic tissue, which can decrease the toxic absorption, will improve the success rate for treatment of the crush syndrome patients when being assisted with the hemodialysis." 05/01/1962 - "[Crush syndrome and its treatment by the method of hemodialysis with the use of the "artificial kidney" apparatus]." 02/01/2010 - "Acute renal failure (ARF) related to crush syndrome is usually treated with hemodialysis. "