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Crush Syndrome

Toxic substances released from muscles after prolonged compression cause acute kidney failure.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Crush Syndrome?

Crush syndrome is characterized by ischemic necrosis of muscle tissue under prolonged pressure followed by reperfusion, releasing myoglobin, potassium, and other toxins into the circulation.

Acute kidney failure, hyperkalemia, metabolic acidosis, and life-threatening arrhythmias may develop. It is common in earthquakes, traffic crashes, and being trapped under rubble.

Initiating fluid therapy BEFORE extrication greatly reduces mortality. It was a major issue in Türkiye during the Marmara and Kahramanmaraş earthquakes.

Symptoms

Pain, swelling, and sensory loss in the crushed limb
Dark (red-brown) urine
Oliguria or anuria
Weakness, nausea, and muscle weakness
Confusion
Cardiac arrhythmia from hyperkalemia

Risk Factors

Long entrapment under earthquake rubble
Being pinned under a vehicle in a traffic accident
Construction accident
War or bombing events
Prolonged immobility in the same position after loss of consciousness
Prior compartment syndrome

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Every patient extracted from rubble should be handed off to medical teams via 112
  • Trauma patients with dark urine require emergency assessment
  • Bedbound elderly with unrecognized pressure injury should be evaluated
  • Do not delay care for muscle pain and decreased urine output

Treatment Methods

01
Early IV fluid initiation while still entrapped
02
Aggressive saline-based fluid resuscitation
03
Urine alkalinization with sodium bicarbonate
04
Hyperkalemia and arrhythmia treatment
05
Emergency hemodialysis when needed
06
Fasciotomy if compartment syndrome develops

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.