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Crush syndrome (Presentation (Spectrum, asymptomatic to life threatening…
Crush syndrome
Presentation
Spectrum, asymptomatic to life threatening electrolyte imbalance, hypovolaemic shock and ARF
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Oliguria, discoloured urine
Pathophysiology
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Renal impairment compounded by: hypotension, dehydration
Electrolyte derrangement - hyperkalaemia from damaged muscle, hyperphosphataemia, hypocalcaemia
Investigation
Bloods - CK (proportional to muscle injury, at least 5 x normal
Metab acidosis (lactic acidosis, RF and titratable acids)
Myoglobin
Haem containing protein, facilitates transport of oxygen in muscle and stores oxygen in muscle
In large quantities, exhausts plasma protein binders - free to filter across glomerulus and enter renal tubules (tubular obstruction, renal vasoconstriction, tubular damage by oxidative injury)
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Definition - Acute oliguric renal failure following trauma, usually involving impaired circulation of a limb. May occur in direct trauma or in patients who lie on limb for prolonged periods