Zhang Meng-Wan, Tan Fu-Qin, Yang Jia-Rong, Yu Jian-Guang
Department of Pharmacy, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Pharmacol. 2024 Sep 20;15:1472971. doi: 10.3389/fphar.2024.1472971. eCollection 2024.
Crush syndrome often occurs after severe crush injury caused by disasters or accidents, and is associated with high mortality and poor prognosis. Cardiovascular complications, such as cardiac arrest, hypovolemic shock, and hyperkalemia-related cardiac dysfunction, are the primary causes of on-site death in crush syndrome. Prehospital evaluation, together with timely and correct treatment, is of great benefit to crush syndrome patients, which is difficult in most cases due to limited conditions. Based on current data and studies, early fluid resuscitation remains the most important on-site treatment for crush syndrome. Novel solutions and drugs used in fluid resuscitation have been investigated for their effectiveness and benefits. Several drugs have proven effective for the prevention or treatment of cardiovascular complications in crush syndrome, such as hypovolemic shock, hyperkalemia-induced cardiac complications, myocardial ischemia/reperfusion injury, ventricular dysfunction, and coagulation disorder experimentally. Moreover, these drugs are beneficial for other complications of crush syndrome, such as renal dysfunction. In this review, we will summarize the existing on-site treatments for crush syndrome and discuss the potential pharmacological interventions for cardiovascular complications to provide clues for clinical therapy of crush syndrome.
挤压综合征常发生于由灾害或事故导致的严重挤压伤之后，且与高死亡率和不良预后相关。心血管并发症，如心脏骤停、低血容量性休克以及与高钾血症相关的心脏功能障碍，是挤压综合征现场死亡的主要原因。院前评估以及及时、正确的治疗对挤压综合征患者大有裨益，但在大多数情况下，由于条件有限，这很难做到。基于目前的数据和研究，早期液体复苏仍然是挤压综合征最重要的现场治疗方法。已对液体复苏中使用的新型溶液和药物的有效性和益处进行了研究。几种药物已被证明对预防或治疗挤压综合征中的心血管并发症有效，如在实验中对低血容量性休克、高钾血症引起的心脏并发症、心肌缺血/再灌注损伤、心室功能障碍和凝血障碍有效。此外，这些药物对挤压综合征的其他并发症，如肾功能障碍也有益处。在本综述中，我们将总结现有的挤压综合征现场治疗方法，并讨论心血管并发症的潜在药物干预措施，以为挤压综合征的临床治疗提供线索。
