A 30 year old male rock climber was rescued from under a large boulder after hiking in the mountains. He sustained a crushing injury to his left lower extremity, include a broken tibia and fibula
Labwork drawn two days after his admission to the hospital shows impaired kidney function. What condition would you suspect? a. pulmonary embolism
b. compartment syndrome
c. rhabdomyolysis
d. gangrene
C
Crushing injuries most commonly cause rhabdomyolysis, the release of myoglobulin (muscle protein) from damaged muscle cells. Myoglobin, creatine kinase (CK), and other inflammatory mediators escape from the injured muscle tissue into the circulation. The circulating myoglobin, filtered by the kidneys, can precipitate, causing renal tubular obstruction. About 30% of rhabdomyolysis cases will have acute renal failure. Two other major problems are respiratory distress from muscle weakness and fluid and electrolyte imbalance. Standard treatment includes IV fluids to maintain circulating blood volume and renal perfusion so the myoglobin is flushed from the kidneys.
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Fill in the blank(s) with correct word