Crush injury or traumatic
rhabdomyolysis is caused by crushing of large muscule mass, usually of the femoral and gluteal compartment.
Crush syndrome is general manifestation of
crush injury with
renal failure (ARF). ARF is caused by deposition of
myoglobin in distal tubules. The concentration of serum creatin phosphokinase is an
indicator of the extent of injured muscule. The serum concentration of
myoglobin is an
indicator of the extent of injured muscule and the main cause of development of
crush syndrome. In a prospective study the concentration of
myoglobin and CPK was measured in 81 patients with
injuries of lower extremities and pelvis as a part of severe
trauma. The increase of CPK concentration above 1000 U/L was measured in all patients. The increase of CPK concentration above 2000 U/L was measured in 78 (96.3%) patients. The increase of
myoglobin concentration of >700 mcg/L was measured in 19 (23.5%) patients. In the group of 19 patients with CPK concentration of >2000 U/L and
myoglobin concentration of >700 mcg/L
crush syndrome developed in 6 (7.4%) patients with
oliguria (urin output <50 ml/h) and the increase of serum
potassium, phosphate and
creatinine concentrations. The decrease of CPK and
myoglobin concentrations was achieved in 5 patients during 10-12 days and 1 patient with associated craniocrebral injury died.