Crush Syndrome: A Review of Current Knowledge

Abstract

Crush syndrome ( CS ) is a medical condition that can occur when muscle tissue is severely damaged and releases myoglobin into the bloodstream. Recent studies have advanced our understanding of its pathophysiology and management, which can result in renal failure, cardiac arrhythmias, and even death if not rapidly and adequately managed. The condition can be caused by traumatic injuries, natural disasters, and industrial accidents, and its incidence varies depending on the underlying cause of the injury. Rapid and controlled release of the compressive force, aggressive fluid resuscitation, and electrolyte monitoring are the mainstays of management, but new therapies such as remote ischemic preconditioning and mesenchymal stem cell therapy are emerging. Prognostic factors that can inform clinical decision-making and improve patient outcomes include the extent of muscle damage, the timing and effectiveness of treatment, and the presence of associated injuries or comorbidities. The pathophysiology of crush syndrome is complex and multifactorial, involving a combination of direct tissue damage, toxic effects of cellular components released into the bloodstream, dysregulated immune responses, and activation of various physiological systems such as the renin-angiotensin-aldosterone system (RAAS). Early recognition and rapid, effective management of crush syndrome are essential to prevent its devastating complications.