Prevention of Crush Syndrome through Aggressive Early Resuscitation: Clinical Case in a Buried Worker

Prehosp Disaster Med. 2016 Jun;31(3):340-2. doi: 10.1017/S1049023X16000327. Epub 2016 Mar 28.

Abstract

Introduction Crush syndrome, of which little is known, occurs as a result of compression injury to the muscles. This syndrome is characterized by systemic manifestations such as acute kidney injury (AKI), hypovolemic shock, and hydroelectrolytic variations. This pathology presents high morbidity and mortality if not managed aggressively by prehospital care. Clinical Case A 40-year-old worker was rescued after being buried underground in a ditch for 19 hours. The patient was administered early resuscitation with isotonic solutions and monitored during the entire rescue operation. Despite having increased plasma levels of total creatine kinase (CK), the patient did not develop AKI or hydroelectrolytic variations.

Conclusion: Aggressive early management with isotonic solutions before hospital arrival is an effective option for nephron-protection and prevention of crush syndrome. Mardones A , Arellano P , Rojas C , Gutierrez R , Oliver N , Borgna V . Prevention of crush syndrome through aggressive early resuscitation: clinical case in a buried worker. Prehosp Disaster Med. 2016;31(3):340-342.

Keywords: ABC airway; AKI acute kidney injury; ATLS Advanced Trauma Life Support; CK creatine kinase; acute kidney injury; breathing; circulation; crush syndrome; rhabdomyolysis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Crush Syndrome / physiopathology
  • Crush Syndrome / prevention & control*
  • Disasters*
  • Fluid Therapy*
  • Humans
  • Male
  • Resuscitation / methods*
  • Treatment Outcome