What is Crush Syndrome?
What is Crush Syndrome? Crush syndrome is a set of overall clinical pathologies that occur when a significant compressive force has been applied to a person for any duration, which results in ischaemia and muscle damage to the site. Crush Syndrome may also occur when a patient has been laying on a hard surface for such a long time that he or she has developped a non-traumatic crush injury, which inolves anearobic metabolism in the area that is compressed against the hard surface of the floor. Crush syndrome is a life-threatening complication of crush injuries and results in high mortality rates.
For example, if a heavy concrete building structure crushes a person’s abdominal region the person will most likely remain alive and potentially conscious until that compressive force is released. Upon releasing the compressive force, lactic acid and K+ ions from damaged cells will be released, potentially leading to sudden death from arrythmias.
Crush Syndrome Mortality
Mortality related to crush syndrome occurs early after the removal of the crushing force or in the weeks afterwards due to secondary injuries.
These are the most common causes of immediate mortality following the release of the crushing force in a patient with crush syndrome:
1. Hyopovolaemia after the compressive force is realeased
2. Sudden release of potassium ions from the area distal to the compressive forces, which then travels to the heart causing fatal arrythmias
3. Sudden release of lactic acid within the circulatory system
Secondary causes of mortality following release of the crushing force include:
1. Release of myoglobin as a result of muscle compression at injury site and distally, leads to large myoglobin cells circulating and becoming blocking the glomerelus from filtering blood within the kidneys, this results in renal failure. This is fundamentally, rhabdomylosis.
Established Signs and Symptoms of Crush Injury
The following are six well defined signs and symptoms of crush injury:
- ischaemic muscle necrosis
- circulating myoglobin and myoglobinuria
- raised serum potassium (hyperkalaemia)
- metabolic acidosis
- hypovolaemic shock
- renal failure