The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Crush Syndrome and Rhabdomyolysis

Systemic complications develop after prolonged compression of muscle mass; aggressive fluid therapy is life-saving.

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 and Rhabdomyolysis?

Crush syndrome is the systemic injury that develops after prolonged compression of large muscle groups, with myoglobin and intracellular contents released into the circulation following decompression.

Massive muscle necrosis leads to hyperkalaemia, metabolic acidosis, hypocalcaemia, hyperphosphataemia and pigmented acute kidney injury.

Earthquake, building collapse, trauma and prolonged immobility are typical causes; pre-extrication aggressive fluid therapy and electrolyte management determine outcome.

Symptoms

Pain, swelling and weakness in the trapped extremity
Dark, tea-coloured urine (myoglobinuria)
Hypotension and tachycardia after extrication
Cardiac arrhythmia and ECG changes from hyperkalaemia
Reduced urine output and progression to anuria
Compartment syndrome findings (tense, pulseless extremity)

Risk Factors

Earthquake, building collapse and major industrial accidents
Compression duration longer than four to six hours
Large muscle mass involvement (thigh, gluteal, back muscles)
Pre-existing dehydration
Prolonged immobility from intoxication or cerebrovascular event
Delayed extrication and lack of pre-rescue fluid therapy

When to See a Doctor?

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

  • All trapped patients must be transferred to a centre with dialysis capacity
  • Hyperkalaemia ECG changes (peaked T, wide QRS) require immediate intervention
  • Dark urine, oliguria and rising creatine kinase mandate intensive care monitoring
  • Compartment syndrome suspicion needs urgent surgical evaluation

Treatment Methods

01
Pre-extrication 1 to 1.5 L/h isotonic saline if possible
02
Aggressive fluid resuscitation targeting urine output of 200 to 300 mL/h
03
Hyperkalaemia treatment (calcium, insulin-glucose, beta-2 agonist, dialysis)
04
Urine alkalinisation with sodium bicarbonate (target pH greater than 6.5)
05
Early dialysis when oliguria, severe hyperkalaemia or volume overload develops
06
Fasciotomy and surgical decompression in compartment syndrome

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.

Learn About Acil Servis Department

Let us help you

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

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Heart Attack First Aid

Acil Servis

Quick recognition and an emergency call in a heart attack dramatically improve the chance of survival.

Stroke Symptoms and FAST Test

Acil Servis

The FAST (Face, Arms, Speech, Time) test is the most practical method for early detection of stroke.

Anaphylaxis (Anaphylactic Shock)

Acil Servis

Anaphylaxis is a severe systemic allergic reaction; epinephrine injection and 112 are the most critical initial interventions.

Respiratory Failure

Acil Servis

Respiratory failure is a life-threatening state characterized by low blood oxygen or rising carbon dioxide.

Poisoning First Aid

Acil Servis

In poisoning, identifying the correct substance and knowing when not to induce vomiting is critical.

Burn Treatment and First Aid

Acil Servis

Emergency treatment for burns varies by degree and extent, starting with cooling and extending to specialist care.

Head Trauma First Aid

Acil Servis

Regardless of the impact severity in head trauma, emergency neurological evaluation is mandatory if there is any change in consciousness.

Emergency Assessment of Chest Pain

Acil Servis

In a patient with chest pain, ECG and cardiac biomarkers rapidly help to distinguish heart attack and pulmonary embolism from other causes.

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.