Crush Injuries and Rhabdomyolysis

Posted by e-Medical PPT Wednesday, October 20, 2010
Rhabdomyolysis is the rapid breakdown of skeletal muscle due to injury to muscle tissue. The muscle damage may be caused by physical (e.g., crush injury), chemical, or biological factors. The destruction of the muscle leads to the release of the breakdown products of damaged muscle cells into the bloodstream; some of these, such as myoglobin, are harmful to the kidney and may lead to acute kidney failure. Treatment is with intravenous fluids, and dialysis or hemofiltration if necessary.
Most cases of rhabdomyolysis develop as a result of muscle injury or strain, or other external causes.If the swelling is very rapid (such as after being released from a collapsed building), low blood pressure and shock may be present due to depletion of fluid from the bloodstream. Swelling of the damaged muscle occasionally leads to compartment syndrome, the compression by swollen muscle of surrounding tissues in the same fascial compartment. Release of the components of muscle tissue into the bloodstream leads to disturbances in electrolytes, causing nausea, vomiting, confusion, coma and cardiac arrhythmias.Furthermore, damage to the kidneys may lead to dark urine or oliguria or anuria. Finally, disruptions in blood clotting may lead to the development of a state called disseminated intravascular coagulation.

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