Management of crush syndrome.
Our experience in treating seven patients with severe crush injury of the lower limbs is described. They were brought to hospital 12 h after rescue and had no treatment until then. All seven developed acute renal failure due to myoglobinuria and dehydration. Five were anuric and three non-oliguric. All developed severe sepsis and two had also acute respiratory failure. No bleeding tendency was observed. They were treated along the following lines: early extensive fasciotomy and removal of dead tissues; early fluid challenge; early peritoneal dialysis and/or hemodialysis; high caloric, high protein nutrition; vigorous antibiotic therapy when infection was evident. There were no deaths in our patients. Our management and results are discussed and compared with those in the literature.
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003444:Crush Syndrome / Q000628:therapy*; D003646:Debridement; D000071938:Fasciotomy; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007869:Leg Injuries / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012131:Respiratory Insufficiency / Q000628:therapy; D018805:Sepsis / Q000628:therapy; D012774:Shock, Traumatic / Q000628:therapy*
D000900:Anti-Bacterial Agents