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: 259 relevant articles (15 outcomes, 31 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Rhabdomyolysis
2.	Acute Kidney Injury (Acute Renal Failure)
3.	Inflammation (Inflammations)
4.	Reperfusion Injury
5.	Hyperkalemia

Experts

1.	Murata, Isamu: 10 articles (05/2022 - 06/2011)
2.	Inoue, Yutaka: 8 articles (05/2022 - 06/2012)
3.	Kanamoto, Ikuo: 8 articles (05/2022 - 06/2012)
4.	Kobayashi, Jun: 8 articles (05/2022 - 06/2011)
5.	Fu, Ping: 6 articles (02/2020 - 07/2011)
6.	Zhang, Ling: 4 articles (01/2016 - 07/2011)
7.	Fan, Haojun: 3 articles (02/2022 - 11/2020)
8.	Hou, Shike: 3 articles (02/2022 - 11/2020)
9.	Li, Ning: 3 articles (02/2022 - 11/2020)
10.	Wang, Pengtao: 3 articles (02/2022 - 11/2020)

Drugs and Biologics

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

1.	urinastatin (MR 20)IBA 04/01/2020 - "Here, we explored the effect and the potential mechanism of ulinastatin on crush syndrome-induced acute kidney injury (CSAKI). " 04/01/2020 - "Ulinastatin ameliorates acute kidney injury induced by crush syndrome inflammation by modulating Th17/Treg cells." 01/01/1997 - "Prostaglandin E1 and ulinastatin (a protease inhibitor) were also effective for recovery from the crush syndrome. "
2.	ZincIBA 01/01/2022 - "The findings of our study suggest that zinc chelators contributed to the resolution of exacerbation of the inflammatory response and attenuation of muscle breakdown in the acute phase after crush syndrome. " 01/01/2022 - "In addition, our strategy of attenuation of the acute inflammatory reaction by zinc chelators may provide a promising therapeutic strategy not only for crush syndrome, but also for other diseases driven by inflammatory reactions." 01/01/2022 - "Since free zinc ion play a critical role in the immune system and the function of neutrophils is impaired by zinc depletion, we hypothesized that the administration of a zinc chelator would be effective for suppressing the inflammatory reaction at the site of ischemia-reperfusion injury and for improving of the pathology of crush syndrome. " 01/01/2022 - "Zinc chelator treatment in crush syndrome model mice attenuates ischemia-reperfusion-induced muscle injury due to suppressing of neutrophil infiltration."
3.	Chelating AgentsIBA 01/01/2022 - "The findings of our study suggest that zinc chelators contributed to the resolution of exacerbation of the inflammatory response and attenuation of muscle breakdown in the acute phase after crush syndrome. " 01/01/2022 - "In addition, our strategy of attenuation of the acute inflammatory reaction by zinc chelators may provide a promising therapeutic strategy not only for crush syndrome, but also for other diseases driven by inflammatory reactions." 01/01/2022 - "Since free zinc ion play a critical role in the immune system and the function of neutrophils is impaired by zinc depletion, we hypothesized that the administration of a zinc chelator would be effective for suppressing the inflammatory reaction at the site of ischemia-reperfusion injury and for improving of the pathology of crush syndrome. " 01/01/2022 - "Zinc chelator treatment in crush syndrome model mice attenuates ischemia-reperfusion-induced muscle injury due to suppressing of neutrophil infiltration."
4.	Atorvastatin (Lipitor)FDA Link 12/19/2017 - "The reno-protective effects of atorvastatin in crush syndrome and rhabdomyolysis:is there a dilemma?" 12/19/2017 - "Larger studies with different atorvastatin doses are required to define the role of this drug in the treatment of renal ischemia/reperfusion injury during crush syndrome." 12/19/2017 - ": This is the first study determining the role of atorvastatin in the treatment of renal ischemia/reperfusion injury in a crush syndrome and rhabdomyolysis model setting. " 12/19/2017 - "Background/aim: We aim to determine the effects of low-dose atorvastatin treatment together with crush fluid resuscitation on renal functions and muscle enzyme levels in a rat model of crush syndrome. "
5.	Creatine Kinase (Creatine Phosphokinase)IBA 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." 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. " 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. " 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. " 03/31/2021 - "To review a large cohort of patients with so-called myorenal or crush syndrome and assess the biochemical markers of venous bicarbonate and creatine kinase as predictors for the development of acute kidney injury (AKI). "
6.	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. " 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. " 07/01/2001 - "Influence of hypothalamic proline-rich peptide on the level of [14C]glucose utilization during crush syndrome."
7.	Peptides (Polypeptides)IBA 01/01/2023 - "Based on our previous finding that RIAKI depends on leukocyte extracellular traps (ETs), we aimed to develop a novel medium-molecular-weight peptide to provide clinical treatment of Crush syndrome. " 01/01/2023 - "In conclusion, we developed a novel medium-molecular-weight peptide that could potentially treat patients with rhabdomyolysis and protect their renal function, thereby increasing the survival rate of victims affected by Crush syndrome." 01/01/2023 - "Precision engineered peptide targeting leukocyte extracellular traps mitigate acute kidney injury in 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. " 07/01/2001 - "Influence of hypothalamic proline-rich peptide on the level of [14C]glucose utilization during crush syndrome."
8.	Bicarbonates (Hydrogen Carbonate)IBA 04/25/2017 - "Validating the utilisation of venous bicarbonate as a predictor of acute kidney injury in crush syndrome from sjambok injuries." 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." 03/31/2021 - "To review a large cohort of patients with so-called myorenal or crush syndrome and assess the biochemical markers of venous bicarbonate and creatine kinase as predictors for the development of acute kidney injury (AKI). "
9.	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)."
10.	anisodamineIBA 11/22/2016 - "Combined administration of anisodamine and neostigmine rescued acute lethal crush syndrome through α7nAChR-dependent JAK2-STAT3 signaling." 01/01/2019 - "Anisodamine Ameliorates Hyperkalemia during Crush Syndrome through Estradiol-Induced Enhancement of Insulin Sensitivity."

Therapies and Procedures

1.	Fasciotomy 01/01/2002 - "The objectives of this study were to identify independent predictors of physical outcome in patients suffering from crush syndrome and to clarify the influence of fasciotomy on outcomes. " 07/27/2023 - "Late fasciotomy should not be preferred in crush syndrome. " 01/01/2005 - "Fasciotomy in crush syndrome patients: debates continue." 07/01/2003 - "Does fasciotomy hurt the patients with crush syndrome?" 05/01/2003 - "Prompt fasciotomy in earthquake victims will be both life saving and can prevent some of the severe and dangerous complications after crush syndrome."
2.	Therapeutics 01/01/1989 - "Employment of these tests for the examination and monitoring the treatment of patients who were injured in the earthquake in Armenia has helped quantitatively assess the structural and functional shifts in the vital organs and injured limbs in the crush syndrome, thus being valuable for the organization and monitoring the efficacy of therapy and for predicting the outcome of injury." 11/01/2020 - "Emerging medical therapies in crush syndrome - progress report from basic sciences and potential future avenues." 09/01/2010 - "Treatment of patients with crush syndrome following mass disasters is even more problematic as hundreds of patients are admitted to hospitals and need therapy at once. " 12/01/2004 - "[The surgical tactics and efferent therapy used in crush syndrome treatment]." 10/01/1997 - "Our findings support current therapeutic strategies for crush syndrome, despite the long delay to initiation of intensive therapy. "
3.	Continuous Renal Replacement Therapy 01/01/2016 - "[Continuous Veno-venous Hemofiltration in Goat Model with Crush Syndrome]." 02/01/2013 - "Management of 7 earthquake crush syndrome victims with long-term continuous renal replacement therapy." 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). "
4.	Fluid Therapy (Oral Rehydration Therapy) 01/01/2020 - "Crush syndrome (CS), a serious medical condition, which is characterized by damage to myocytes due to pressure and is associated with high mortality, even when patients receive fluid therapy. " 12/01/2019 - "Crush syndrome (CS), a serious medical condition characterised by damage to the muscle cells due to pressure, is associated with high mortality, even when patients receive fluid therapy during transit to the hospital or admission to the hospital. " 06/14/2019 - "Dogma #2 addresses the treatment of crush syndrome patients with aggressive fluid therapy using NaCl 0.9%. " 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."
5.	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."