The protective effect of fasciotomy combined with hypertonic saline flushing for crush syndrome in rats.

Abstract: In natural disasters such as earthquakes and landslides, the main problem that wounded survivors are confronted with is Crush Syndrome (CS). The aim of this study was to explore more convenient and effective early treatment measures for it.In the present study, we investigated the protective effect of fasciotomy combined with different concentration of hypertonic saline flushing with CS rats. CS model was prepared by compressing the buttocks and both lowering limbs of rats with 7.5 kg dumbbell for 4 hours. The rats were divided into 10 groups, which were normal control group, model group, incision without flushing group, 0.45%, 0.9%, 3%, 5%, 7% saline group, 3%-0.45% and 7%-0.45% saline alternating flushing group respectively. 6 hours after the treatment, the blood was sampled for measurement of the potassium, calcium, AST, ALT, Cr, Urea, myoglobin, and lactic acid content. The blood flow of the compressed tissue and kidneys, the pathological changes of the kidneys and the survival rate of 3%-0.45% saline alternating flushing group were also observed.The experimental results showed that fasciotomy alone for treatment cannot improve the presentation of CS of rats. Instead, hypertonic saline flushing significantly improved the AST, ALT, Cr, Urea indices, blood flow of muscles and kidneys. It also enormously decreased the blood K+, myoglobin, lactic acid concentration and slight increased the blood Ca2+. Among them, alternating flushing with 3%-0.45% saline had the best therapeutic effect on CS. Finally, it can be found that 3%-0.45% saline treatment regimen dramatically raised the survival rate of CS rats.All in all, this study suggests that fasciotomy combined with hypertonic saline flushing is a good therapeutic approach for CS.