Gafar Abubakir Osman Hagwa, Elfatih Elbadri Mohammed, Hamadelniel Alhadi Ibrahim Adil, Ibrahim Ahmed S, Ayyub Aisha, Mohamed Ahmed, Sahnon Abaker Sahnon Abdelrahman, H J Alkhazendar Jarallah, Alkhazendar Aliaa H, Awan Manahil
General Practice, Badr Al Samaa Hospital, Makkah, SAU.
Orthopedics, Khorfakkan Hospital, Sharjah, SAU.
Cureus. 2025 Aug 7;17(8):e89592. doi: 10.7759/cureus.89592. eCollection 2025 Aug.
Crush syndrome remains a life-threatening complication of traumatic injuries, especially in mass casualty and disaster scenarios. This systematic review evaluates the current clinical and mechanistic understanding of crush-related pathophysiology, anatomical impact, and renal complications, with a focus on therapeutic interventions. Studies were selected using the PICO framework and analyzed under PRISMA guidelines. A total of six studies, including narrative reviews, clinical trials, and a systematic review, were included. Core findings highlighted ischemia-reperfusion injury, rhabdomyolysis, and ferroptosis as key drivers of systemic toxicity, often culminating in acute kidney injury (AKI). Anatomically, prolonged soft tissue compression and necrosis posed serious risks for long-term disability and systemic inflammation. Adjunctive therapies such as hyperbaric oxygen therapy (HBOT) demonstrated potential benefits in wound healing and tissue preservation, though evidence remains limited by study heterogeneity. Overall, this review offers an integrative synthesis of existing knowledge, identifies therapeutic gaps, and emphasizes the need for standardized, evidence-based protocols for managing crush syndrome.
挤压综合征仍然是创伤性损伤的一种危及生命的并发症，尤其是在大规模伤亡和灾难场景中。本系统评价评估了目前对挤压相关病理生理学、解剖学影响和肾脏并发症的临床及机制理解，重点关注治疗干预措施。使用PICO框架选择研究，并根据PRISMA指南进行分析。共纳入六项研究，包括叙述性综述、临床试验和一项系统评价。核心发现强调缺血再灌注损伤、横纹肌溶解和铁死亡是全身毒性的关键驱动因素，常最终导致急性肾损伤（AKI）。在解剖学上，长时间的软组织压迫和坏死对长期残疾和全身炎症构成严重风险。辅助治疗如高压氧治疗（HBOT）在伤口愈合和组织保存方面显示出潜在益处，尽管研究异质性使证据仍然有限。总体而言，本综述对现有知识进行了综合总结，确定了治疗差距，并强调需要标准化的、基于证据的方案来管理挤压综合征。
