Crush injury to the lower limbs. Treatment of the local injury.

Reis, N. D.; Michaelson, Moshe

doi:10.2106/00004623-198668030-00015

Cited by 171 publications

(67 citation statements)

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“…3 Therefore, treatment preferably should be started as soon as possible, even at the site of catastrophe. 4,5 In our patients, preventive treatment against acute renal failure began relatively late. Therefore, a longer period of being trapped, severe muscle injury leading to compartment syndrome, and rhabdomyolysis seem to be responsible for the development of acute renal failure in these patients.…”

Section: Discussionmentioning

confidence: 86%

Renal Doppler ultrasonographic findings in earthquake victims with crush injury.

Keven

Ateş

Yağmurlu

et al. 2001

J of Ultrasound Medicine

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people had renal complications, and 477 needed hemodialysis treatment because of acute renal failure due to crush injury. Our objective was to use Doppler ultrasonography as a noninvasive procedure to provide renal hemodynamic information. Methods. We evaluated 9 patients with severe crush injury by using Doppler ultrasonography to measure renal resistive indexes within 16 to 32 hours after the earthquake and 6 weeks later. All patients had acute renal failure and underwent hemodialysis. Results. All measured initial resistive indexes were high (mean ± SD, 0.83 ± 0.08), and they were correlated with the number of hemodialysis sessions (r = 0.703; P = .034), the duration of hemodialysis treatment (r = 0.819; P = .007), and oligoanuria (r = 0.937; P < .0001). All patients recovered from the acute renal failure, and repeated Doppler ultrasonography showed significant decreases in resistive indexes (0.59 ± 0.07; P < .01) and renal lengths (P < .05). Conclusions. In crush injury, measurement of renal resistive indexes can be useful for the prognosis of recovery from acute renal failure.

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Section: Discussionmentioning

confidence: 86%

Renal Doppler ultrasonographic findings in earthquake victims with crush injury.

Keven

Ateş

Yağmurlu

et al. 2001

J of Ultrasound Medicine

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“…Although the indications and specific circumstances around these procedures are unknown, some experts and organizations advise against guillotine amputations [19,25,47], fasciotomies for acute closed muscle-crush injury [39,48,49,53], and internal fixation [21,25] in disaster and war settings. In addition, the observed ratio of greater than one revision for every primary amputation suggests higher revision rates than those documented in the developed world (25%-30%) [11,28,59].…”

Section: Discussionmentioning

confidence: 99%

Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Sonshine

Caldwell

Gosselin

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Alkalinization of the urine with sodium bicarbonate to prevent the development of ARF after crush injuries and rhabdomyolysis has been supported by numerous animal studies [63,69], case reports [25,53,[83][84][85], and retrospective clinical studies [50,53,84]. Bicarbonate assists in the creation of alkaline urine, which serves to decrease cast formation and lessen the direct toxic effects of myoglobin [63].…”

Section: Managementmentioning

confidence: 99%

“…They went on to state that the excision of noninfected, necrotic tissue is not essential and may delay healing. Reis and Michaelson [85] had to perform above-knee amputations for uncontrolled sepsis in three of six patients who previously had undergone fasciotomies more than 24 hours after injury. They concluded that the sequelae of infection in a crushed extremity are much worse than the late muscle contracture that may result from fibrosis of muscle.…”

Section: Treatment Of Compartment Syndromementioning

confidence: 99%

Crush injury and rhabdomyolysis

Malinoski

Slater

Mullins

2004

Critical Care Clinics

214

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Although clinical syndromes consistent with rhabdomyolysis were recognized in the late 19th and early 20th centuries, the modern history of the crush syndrome begins with Bywaters' and Beal's classic description of the entrapped bombing victims of London during World War II [1 -4]. They reported five cases of crush injury, in which victims had one or more of their extremities trapped under debris for prolonged periods of time. All five patients presented in shock, had swollen extremities, developed dark urine, progressed to renal failure, and eventually died. Histologic examination of the kidney revealed tubular necrosis and pigmented casts. In 1944, Bywaters and Stead identified myoglobin as the urinary pigment and proposed its role in the development of renal failure [5].Large numbers of patients with crush injuries and rhabdomyolysis have been reported after the collapse of mines [6,7], severe beatings [8], and earthquakes [9 -15]. In the United States, alcohol intoxication associated with prolonged muscle compression and seizures is the most common etiology of rhabdomyolysis [16]. Serum creatine kinase (CK) levels correlate with the degree of muscle injury [14] and can be used to assess the severity of rhabdomyolysis. Acute renal failure (ARF) is one of the most serious consequences of rhabdomyolysis and occurs in 4% to 33% of cases, carrying with it a mortality rate of 3% to 50% [17]. Rhabdomyolysis accounts for 5% to 7% of all cases of ARF in the United States [18].This article focuses on the pathophysiology and treatment of myoglobinuric renal failure caused by traumatic rhabdomyolysis and crush injuries.

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Crush injury to the lower limbs. Treatment of the local injury.

Cited by 171 publications

References 0 publications

Renal Doppler ultrasonographic findings in earthquake victims with crush injury.

Renal Doppler ultrasonographic findings in earthquake victims with crush injury.

Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Crush injury and rhabdomyolysis

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