Crush syndrome may be associated with blunt or penetrating muscle trauma, resulting in rhabdomyolysis. This may be complicated by acute renal failure.
Patient selection: crush syndrome
Presentation:
(1) oliguria
(2) elevated serum BUN and creatinine
(3) markedly elevated serum CK
(4) hyperkalemia
(5) hyperphosphatemia
Risk factors for acute renal failure:
(1) delay in management, including delayed recovery
(2) inability to manage appropriately due to inadequate resources
(3) moderate or severe rhabdomyolysis
Transfer of patients to undamaged hospitals with dialysis units improves outcomes.
Risk factors for mortality:
(1) associated thoracic and/or abdominal trauma
(2) DIC and/or thrombocytopenia
(3) respiratory failure
(4) sepsis
