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November 3, 1945

THE CRUSH SYNDROME: REPORT OF FATAL CASE WITHOUT COMPRESSION INJURY

JAMA. 1945;129(10):676-677. doi:10.1001/jama.1945.92860440001008
Abstract

The crush syndrome, also known as compression syndrome with traumatic edema, has been described in British and American literature since 1940. The Medical Research Council of Great Britain has collected data on 100 cases. The typical case is fairly clearcut, and its differential diagnosis is not usually difficult. A patient is admitted with a history of compression injury, usually of an extremity. Definite absence of shock with pronounced hemoconcentration is present.

The pathologic physiology is somewhat better understood than the knowledge of the shock syndrome itself. Often the syndrome follows an initial shock picture. The usual sequence of events is as follows:

Following the recovery from the shock picture, there is a gradual diminution in the urinary output. The urine will be tinted and contain some red blood cells and also a sediment which is almost diagnostic of the syndrome. This sediment, if carefully examined spectroscopically, will prove to be myohemoglobin.

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