Türk Nöroşirürji Dergisi 2023 , Vol 33 , Num 2
Crush Syndrome and Acute Kidney Injury
Engin ONAN1
1Başkent Üniversitesi Tıp Fakültesi Adana Dr. Turgut Noyan Eğitim ve Uygulama Hastanesi, Nefroloji Bilim Dalı, Adana, Türkiye Crush syndrome, also known as traumatic rhabdomyolysis, is a medical condition that causes muscle damage and the release of toxic products such as myoglobin, creatine kinase, and potassium into the bloodstream when a part of the body is crushed. It is usually caused by earthquakes, building collapses, or being trapped under heavy objects for long periods of time. Treatment includes careful management of the patient"s fluid and electrolyte levels to prevent complications. In some cases, surgery may be required to remove damaged tissue or reduce pressure on the affected muscles. In patients who are likely to develop crush syndrome, fluid therapy should be initiated aggressively, if possible, at the time of extraction. Isotonic saline is recommended. If intravenous fluid could not be administered before extraction, intravenous isotonic saline at 1 L/hr for adults should be initiated. Earthquake victims should be evaluated regularly and urine output should be monitored for at least six hours. Close monitoring of hyperkalemia is very important. Potassium-containing fluids should not be used. Mannitol and bicarbonate applications should only be used for special indications. Diuretic therapy is not recommended except for treatment-related hypervolemia. Intermittent dialysis treatment should be initiated in hyperkalemia, hypervolemia, severe acidosis, and uremia. Anahtar Kelimeler : Crush syndrome, Acute kidney injury, Traumatic rhabdomyolysis