After crush injury, patients often experience multiple organ dysfunction syndrome. In this study, we focused on vascular endothelial damage, which is believed to be a possible cause of multiple organ dysfunction syndrome, and revealed a pathological condition of distant organ failure. In particular, the lung is an especially prone target organ at the time of systemic inflammatory invasion after crush injury. We ascertained the effect of antithrombin (AT), which has recently attracted attention for its endothelial protective effects. Using a rat model of crush syndrome, we assessed severity of systemic inflammation and vascular endothelial damage through a blood test and degree of lung injury and centrally focused on morphological analysis of endothelium over time. Crush injury significantly elevated the blood concentration of tissue plasminogen activator-plasminogen activator inhibitor 1 complex, monocyte chemoattractant protein 1, and IL-6. Accumulation of active inflammatory cells (OX-42-positive cells) and expression of von Willebrand factor and vascular cell adhesion molecule 1 significantly increased in the lung 24 h after releasing crush. After 48 h, disarray of alveolar structure and alveolar hemorrhage appeared. Antithrombin administration significantly suppressed accumulation of inflammatory cells, expression of von Willebrand factor and vascular cell adhesion molecule 1, and mortality rate. Our research demonstrates that crush injury induces acute lung injury as distant organ failure, and it would seem that AT administration diminishes vascular endothelial damage and is effective against crush injury.
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http://dx.doi.org/10.1097/SHK.0b013e3181a23ad0 | DOI Listing |
JAMA Netw Open
January 2025
Department of Pediatric Intensive Care Medicine, Life Support Center, Hacettepe University, Ankara, Turkey.
Importance: This study addresses the characteristics, kidney replacement therapy (KRT) modalities, and outcomes in children diagnosed with crush syndrome following an earthquake in Turkey.
Objective: To analyze the associations of different KRT modalities with long-term dialysis dependency and length of stay (LOS) in the pediatric intensive care unit (PICU).
Design, Setting, And Participants: This multicenter, prospective, and retrospective cohort study was conducted across 20 PICUs in Turkey.
Cureus
December 2024
Orthopaedics and Trauma, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Background Trauma is a major public health issue, causing disease and death globally. Injuries can range from mild to severe, requiring different levels of medical attention from a skilled team. Objectives To predict the accuracy of the new trauma score (NTS) and the revised trauma score (RTS) for predicting the mortality of patients presenting in the emergency department of a tertiary care hospital in Karachi.
View Article and Find Full Text PDFNat Commun
January 2025
School of Disaster and Emergency Medicine, Faculty of Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, China.
Rhabdomyolysis or Crush syndrome-related AKI (RM/CS-AKI) has high mortality, and there is no effective early on-site treatment method. The critical pathogenic factor of RM/CS-AKI is the excessive free myoglobin (Mb) in blood circulation. Here, based on the concept of creating a "mobile barrier", we develop an anti-Mb rabbit monoclonal antibody (RabMAb) with high specificity, affinity, stability, and broad species reactivity.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Management of the extensive soft tissue injuries remains a significant challenge in orthopedic and plastic reconstructive surgery. Since the thumb is responsible for 40% of the functions of the hand, saving and reconstructing a mangled thumb is essential for the patient's future.
Case Presentation: This case report describes the management of a severe occupational thumb injury in a 25-year-old white Persian male who sustained an occupational injury to his left thumb, resulting in extensive burn, crush injury to the distal and proximal phalanx, and severe soft tissue damage to the first metacarpal, thenar, and palmar areas.
Eur J Trauma Emerg Surg
January 2025
Liverpool Orthopaedic and Trauma Service, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
Background: Midfoot fractures in polytrauma patients are often an underappreciated injury relative to their other major injuries sustained. In this study, our aim was to explore the mechanisms and patterns of injury in polytrauma related midfoot fractures as compared to single limb injuries.
Setting: Multicentre observational study.
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