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Crush syndrome is caused by prolonged pressure on muscle tissue, leading to rhabdomyolysis. This releases myoglobin and other intracellular contents into the bloodstream, which can cause kidney damage, metabolic abnormalities, and complications affecting other organs. Treatment involves aggressive fluid resuscitation, dialysis if needed to manage kidney dysfunction, and surgery such as fasciotomy to release pressure in compartments. Early medical management is important to prevent further complications from crush syndrome.
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Crush syndrome PPT
Crush syndrome is caused by prolonged pressure on muscle tissue, leading to rhabdomyolysis. It causes systemic effects like kidney failure due to the release of toxins from damaged muscle into the bloodstream. Signs include dark urine, fever, arrhythmias and respiratory failure. Treatment involves aggressive fluid resuscitation, dialysis, antibiotics, surgical debridement of damaged tissue, and fasciotomy to release pressure in compartments. Early fluid resuscitation within 6 hours is key to preventing kidney damage from crush syndrome.
C S.pptx
Crush syndrome is caused by prolonged pressure on muscle tissue, leading to rhabdomyolysis. It causes systemic effects like kidney failure due to the release of myoglobin and other muscle contents into the bloodstream. Clinical features include muscle pain, paralysis, dark urine, fever, arrhythmias and respiratory issues. Treatment involves aggressive fluid resuscitation, dialysis, antibiotics, surgical debridement of necrotic tissue, and fasciotomy to release pressure in compartments. Early medical management is key to preventing complications of crush syndrome like renal failure.
Crush syndrome - Dr Bipul Borthakur
Crush syndrome results from prolonged pressure on muscle tissue, causing rhabdomyolysis. It is characterized by the release of toxic muscle contents into the bloodstream due to cell death. This can cause kidney damage, electrolyte abnormalities, and other systemic effects. Treatment involves aggressive fluid resuscitation, dialysis if needed, and surgery to relieve pressure on muscles through fasciotomy. Early fluid replacement within 6 hours of injury is critical to prevent complications from crush syndrome.
fluids in children maintenance therapy and normal
Total body water is high in fetuses and declines after birth. Two-thirds is intracellular fluid, one-third is extracellular fluid. Hormones like ADH, angiotensin II, aldosterone, and atrial natriuretic factor regulate body fluids and electrolytes. Sodium is the main extracellular ion and levels can become too high (hypernatremia) or too low (hyponatremia). Potassium, calcium, and magnesium also have normal levels and can become abnormal. Acid-base balance is tightly regulated and metabolic acidosis results from low bicarbonate levels. Treatment depends on the underlying cause and severity.
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This document provides information on fluid and electrolyte management in surgical patients. It discusses normal physiology including total body water and its distribution. It then covers various fluid and electrolyte imbalances that can occur such as volume loss, water excess, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, and acid-base imbalances. For each imbalance, it describes the causes, clinical features, and treatment approach. Principles of fluid therapy are also reviewed including indications, advantages, problems, daily electrolyte requirements, and calculations for intravenous fluid drop rates.
Rhabdomyolysis
Rhabdomyolysis is the breakdown of skeletal muscle fibers that results in the release of muscle contents into the bloodstream. This can lead to acute kidney injury through deposition of myoglobin casts in the renal tubules. Treatment involves aggressive fluid resuscitation to prevent renal failure, treatment of hyperkalemia, and alkalinization of urine to prevent tubular obstruction. While bicarbonate and mannitol are commonly used, evidence does not clearly support their benefit over fluid resuscitation alone. Oxygen therapy and antioxidants may help reduce muscle injury. Dialysis may be needed for severe cases with refractory acidosis or hyperkalemia.
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This document provides information on chronic kidney disease (CKD) including its stages, causes, risk factors, clinical manifestations, diagnostic evaluation, medical management including dialysis and renal transplantation, and nursing management. Some key points are: CKD is progressive and irreversible, leading to end-stage renal disease if kidney function becomes too poor. It disproportionately affects African Americans and incidence increases with age. Common causes include diabetes, hypertension, glomerulonephritis. Later stages result in buildup of waste and complications impacting multiple organ systems. Treatment focuses on managing complications, slowing progression, and renal replacement therapies like hemodialysis or transplantation.
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An electrolyte disorder occurs when there is an imbalance in ionized salts like sodium, potassium, calcium, and magnesium in the blood. Electrolytes help regulate pH, fluid balance, and neuromuscular and organ function. Common electrolyte disorders include hypernatremia, hyponatremia, hyperkalemia, hypokalemia, hypercalcemia, and hypocalcemia. Treatment involves identifying the cause, restricting intake of the abnormal electrolyte, and slowly correcting the imbalance to avoid complications like cerebral edema.
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Crush syndrome PPT
Crush syndrome is caused by prolonged pressure on muscle tissue, leading to rhabdomyolysis. It causes systemic effects like kidney failure due to the release of toxins from damaged muscle into the bloodstream. Signs include dark urine, fever, arrhythmias and respiratory failure. Treatment involves aggressive fluid resuscitation, dialysis, antibiotics, surgical debridement of damaged tissue, and fasciotomy to release pressure in compartments. Early fluid resuscitation within 6 hours is key to preventing kidney damage from crush syndrome.
C S.pptx
Crush syndrome is caused by prolonged pressure on muscle tissue, leading to rhabdomyolysis. It causes systemic effects like kidney failure due to the release of myoglobin and other muscle contents into the bloodstream. Clinical features include muscle pain, paralysis, dark urine, fever, arrhythmias and respiratory issues. Treatment involves aggressive fluid resuscitation, dialysis, antibiotics, surgical debridement of necrotic tissue, and fasciotomy to release pressure in compartments. Early medical management is key to preventing complications of crush syndrome like renal failure.
Crush syndrome - Dr Bipul Borthakur
Crush syndrome results from prolonged pressure on muscle tissue, causing rhabdomyolysis. It is characterized by the release of toxic muscle contents into the bloodstream due to cell death. This can cause kidney damage, electrolyte abnormalities, and other systemic effects. Treatment involves aggressive fluid resuscitation, dialysis if needed, and surgery to relieve pressure on muscles through fasciotomy. Early fluid replacement within 6 hours of injury is critical to prevent complications from crush syndrome.
fluids in children maintenance therapy and normal
Total body water is high in fetuses and declines after birth. Two-thirds is intracellular fluid, one-third is extracellular fluid. Hormones like ADH, angiotensin II, aldosterone, and atrial natriuretic factor regulate body fluids and electrolytes. Sodium is the main extracellular ion and levels can become too high (hypernatremia) or too low (hyponatremia). Potassium, calcium, and magnesium also have normal levels and can become abnormal. Acid-base balance is tightly regulated and metabolic acidosis results from low bicarbonate levels. Treatment depends on the underlying cause and severity.
FLUID & ELCTROL-WPS Office.pptx
This document provides information on fluid and electrolyte management in surgical patients. It discusses normal physiology including total body water and its distribution. It then covers various fluid and electrolyte imbalances that can occur such as volume loss, water excess, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, and acid-base imbalances. For each imbalance, it describes the causes, clinical features, and treatment approach. Principles of fluid therapy are also reviewed including indications, advantages, problems, daily electrolyte requirements, and calculations for intravenous fluid drop rates.
Rhabdomyolysis
Rhabdomyolysis is the breakdown of skeletal muscle fibers that results in the release of muscle contents into the bloodstream. This can lead to acute kidney injury through deposition of myoglobin casts in the renal tubules. Treatment involves aggressive fluid resuscitation to prevent renal failure, treatment of hyperkalemia, and alkalinization of urine to prevent tubular obstruction. While bicarbonate and mannitol are commonly used, evidence does not clearly support their benefit over fluid resuscitation alone. Oxygen therapy and antioxidants may help reduce muscle injury. Dialysis may be needed for severe cases with refractory acidosis or hyperkalemia.
Chronic Kidney Injury
This document provides information on chronic kidney disease (CKD) including its stages, causes, risk factors, clinical manifestations, diagnostic evaluation, medical management including dialysis and renal transplantation, and nursing management. Some key points are: CKD is progressive and irreversible, leading to end-stage renal disease if kidney function becomes too poor. It disproportionately affects African Americans and incidence increases with age. Common causes include diabetes, hypertension, glomerulonephritis. Later stages result in buildup of waste and complications impacting multiple organ systems. Treatment focuses on managing complications, slowing progression, and renal replacement therapies like hemodialysis or transplantation.
Dyselectrolytemia in icu
An electrolyte disorder occurs when there is an imbalance in ionized salts like sodium, potassium, calcium, and magnesium in the blood. Electrolytes help regulate pH, fluid balance, and neuromuscular and organ function. Common electrolyte disorders include hypernatremia, hyponatremia, hyperkalemia, hypokalemia, hypercalcemia, and hypocalcemia. Treatment involves identifying the cause, restricting intake of the abnormal electrolyte, and slowly correcting the imbalance to avoid complications like cerebral edema.
Hyponatremia
Hyponatremia is a common electrolyte abnormality seen in clinical practice. It is defined as a serum sodium level below 135 mmol/L. The main types are isotonic, hypertonic, and hypotonic hyponatremia. Causes include diuretic use, liver cirrhosis, heart failure, and SIADH. Diagnosis involves lab tests and imaging. Management depends on severity and rate of onset, with slow correction for chronic cases to avoid osmotic demyelination syndrome. Fluid restriction and vasopressin antagonists are often used to treat euvolemic hyponatremia.
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2. AKI is classified based on location of injury (pre-renal, intrinsic, post-renal), urine output, and severity of decline in renal function. Common causes include sepsis, nephrotoxins, and decreased renal perfusion.
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This document discusses sodium imbalance and hyponatremia. It provides details on:
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- The approach to evaluating hyponatremia by measuring osmolality, estimating volume status, and getting urinary sodium and osmolality levels.
- Specific causes of hyponatremia like SIADH, cerebral salt wasting, and mineralocorticoid deficiency.
- The treatment of hyponatremia depending on if it is acute or chronic and correcting it slowly to avoid osmotic demyelination syndrome.
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2) It describes common electrolyte imbalances like hyponatremia, hypernatremia, hypokalemia, and hyperkalemia and their causes and treatments.
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- 2. DEFINITION • Crush syndrome is the systemic manifestation of RHABDOMYOLYSIS caused by prolonged continuous pressure on muscle tissue. • Crush syndrome includes crush injury and compartment syndrome.
- 3. CAUSES OF CRUSH SYNDROME Immobility against firm surface for > 1 hour • Drug or alcohol intoxication. • Carbon monoxide poisoning. • Cerebrovascular accident. • Head trauma with coma. • Elderly with hip fracture. • Improper positioning of surgical patient. • Assault with beating. • Pneumatic antishock garment(PASG OR MAST)
- 4. PATHOPHYSIOLOGY Stretch of muscle sarcolemma Sarcolemma permeability increases Influx of sodium, water and extracellular calcium into the sarcoplasm
- 5. Results in cellular swelling , ↑sed intracellular calcium , disrupted cellular function & respiration ↓sed ATP production Subsequent myocytic death
- 7. CLINICAL FEATURES • Petechiae , blisters and muscle bruising. • Myalgia, muscle paralysis and sensory deficit are common. • Fever, cardiac arrhythmia, pneumonia, (tea or cola) coloured urine, oliguria and renal failure. • Nausea, vomiting, agitation and delirium are seen in delayed rescue patients
- 9. CONTENTS RELEASED DURING RHABDOMYOLYSIS & THEIR EFFECTS • Hyperkalemia & cardiotoxicity • Provoked by hypocalcemia & hypovolemia. Potassium • Hyperphosphatemia. • Metastatic calcification. Phosphate • Myoglobinuria. • Nephrotoxicity. Myoglobin
- 10. •Elevation of serum ck level Creatine kinase •Disseminated intravascular coagulation Thromboplastin •Metabolic acidosis & aciduria Organic acids
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- 12. • Serum lactic acid, AST, ALT and LDH show steady rise. • Serum urea and creatinine – steep rise after prolonged crush. • Serum potassium show early rise and is predictor for dialysis. • Intracompartmental pressure monitoring if > 30mm Hg fasciotomy may be required.
- 13. TREATMENT Medical management 1.Fluid replacement 2.Ventilatory support 3.Correction of metabolic acidosis 4. Dialysis if required Surgical management 1. Emergency fasciotomy 2.Debridement of nacrotic tissue 3. Delayed VAC and skin grafting
- 14. FLUID RESUSCITATION • It is the mainstay of treatment 0.9% normal saline is preferred. • Early most preferably within first 6 hours is essential. • To counter metabolic acidosis bicarbonate and lactate or even oral citrate is essential. • 50 mmol of bicarbonate for every lit of isotonic saline is used.
- 16. Diuresis- • This is to maintain effective kidney function. • Mannitol diuresis is indicated in setting of compartment syndrome. Dialysis- • Important predictive factors:- 1. Anuria 2. Fluid overload 3. ↑sed creatinine level 4. ↑sed BUN and bicarbonate level
- 17. • Potassium > 7meq/l is independent and important predictive factor for dialysis. • It may be required for 15 days. Hyperbaric oxygen- It ↓ses outflow from vascular compartment Reduces tissue edema promotes wound healing by fibroblast proliferation Reduces anaerobic bacterial growth
- 18. • Multiple broad spectrum non nephrotoxic antibiotic may be needed. Surgery- • Laparotomy and thoracotomy with debridement of necrosed muscles. • Fasciotomy if compartmental pressure rises can be done as early as possible. • Fractures need fixation and conservative amputations may have to be performed.