Myohaemoglobin in the urine of air raid casualties with crushing injury

Bywaters, E. G. L.; Delory, G. E.; Rimington, C.; Smiles, J.

doi:10.1042/bj0351164

Cited by 82 publications

(20 citation statements)

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“…This condition, crush syndromeor mechanical muscle crush injury-was reported by British physician Eric Bywaters during the London Blitz [17,18]. Syndrome victims had massive muscle damage and subsequently died from renal failure.…”

Section: Crush Injuries Crush Syndrome Compartment Syndromementioning

confidence: 97%

“…Also, oft-reported field experience in different disaster zones indicates high rates of infection and associated amputation no matter what the circumstances when fasciotomies are performed in the presence of crush syndrome [9][10][11][17][18][19][20][21][22][23][24][25]. In hypoxic tissues, infection control and healing mechanisms are impaired, increasing the risk of infection, and problems with wound healing are more common than after other injuries.…”

Section: Crush Injuries Crush Syndrome Compartment Syndromementioning

confidence: 99%

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Amputations in natural disasters and mass casualties: staged approach

Wolfson

2012

International Orthopaedics (SICOT)

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Amputation is a commonly performed procedure during natural disasters and mass casualties related to industrial accidents and military conflicts where large civilian populations are subjected to severe musculoskeletal trauma. Crush injuries and crush syndrome, an often-overwhelming number of casualties, delayed presentations, regional cultural and other factors, all can mandate a surgical approach to amputation that is different than that typically used under non-disaster conditions. The following article will review the subject of amputation during natural disasters and mass casualties with emphasis on a staged approach to minimise post-surgical complications, especially infection.

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Section: Crush Injuries Crush Syndrome Compartment Syndromementioning

confidence: 97%

Section: Crush Injuries Crush Syndrome Compartment Syndromementioning

confidence: 99%

Amputations in natural disasters and mass casualties: staged approach

Wolfson

2012

International Orthopaedics (SICOT)

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“…Furthermore, through an elegant series of experiments, Bywaters demonstrated that myoglobinuria led to nephrotoxic effects when the urine was acidic but not when it was alkaline. [40][41][42] On the basis of these observations, Bywaters was the first author to suggest that management of muscle crush syndrome should consist of copious rehydration combined with infusion and ingestion of bicarbonate ions to achieve alkalinization of urine. 42 Towards the end of World War II, London was bombed again.…”

Section: Professor Severin Ringoir -Pioneer Of Nephrology In Ghent Unmentioning

confidence: 99%

Wars, disasters and kidneys

Lameire¹

2014

Acta Clinica Belgica

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This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis' as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes.

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“…In more modern times, German military literature referred to rhabdomyolysis as crush syndrome, and the disease and its mechanisms were well described in World War II during the Blitz of London in 1941. Bywaters identified myoglobinuria as the cause of renal failure in five patients from the London Blitz [9].…”

Section: Rhabdomyolysis In Historymentioning

confidence: 99%

Rhabdomyolysis: a review, with emphasis on the pediatric population

2010

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Rhabdomyolysis is a common clinical syndrome and accounts for 7% of all cases of acute kidney injury (AKI) in the USA. It can result from a wide variety of disorders, such as trauma, exercise, medications and infection, but in the pediatric population, infection and inherited disorders are the most common causes of rhabdomyolysis. Approximately half of patients with rhabdomyolysis present with the triad of myalgias, weakness and dark urine. The clinical suspicion, especially in the setting of trauma or drugs, is supported by elevated creatinine kinase levels and confirmed by the measurement of myoglobin levels in serum or urine. Muscle biopsy and genetic testing should be performed if rhabdomyolysis is recurrent or metabolic myopathy is suspected. Early recognition is important to prevent AKI through the use of aggressive hydration. Prevention is important in patients with inherited forms, but novel therapies may be developed with the better understanding of the pathophysiology and genetics of rhabdomyolysis.

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Myohaemoglobin in the urine of air raid casualties with crushing injury

Cited by 82 publications

References 1 publication

Amputations in natural disasters and mass casualties: staged approach

Amputations in natural disasters and mass casualties: staged approach

Wars, disasters and kidneys

Rhabdomyolysis: a review, with emphasis on the pediatric population

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