Takefumi Nakayama1, Masanori Fujita2, Masayuki Ishihara3, Miya Ishihara3, Sho Ogata4, Yoritsuna Yamamoto5, Masafumi Shimizu6, Tadaaki Maehara1, Yasuhiro Kanatani7, Shoichi Tachibana5. 1. Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan. 2. Division of Environmental Medicine, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan. Electronic address: bxb01424@nifty.com. 3. Department of Medical Engineering, National Defense Medical College, Tokorozawa, Saitama, Japan; Division of Biomedical Engineering, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan. 4. Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan. 5. Division of Environmental Medicine, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan. 6. Tokorozawa Meisei Hospital, Tokorozawa, Saitama, Japan. 7. Department of Health Crisis Management, National Institute of Public Health, Wako, Saitama, Japan.
Abstract
BACKGROUND: Crush syndrome (CS) has been reported in disasters, terrorist incidents, and accidents, and the clinical and pathologic picture has gradually been clarified. Few lethal and reproducible animal models of CS with use of a quantitative load are available. A new model is needed to investigate pathologic and therapeutic aspects of this injury. MATERIALS AND METHODS: Using a device built from commercially available components, both hindlimbs of anesthetized rats were respectively compressed for 6 h using 3.6-kg blocks. The effects of trunk warming alone without compressed hindlimbs (Group A), non-warming at room temperature (Group B), whole-body warming including compressed hindlimbs (Group C), or warming of compressed hindlimbs alone (Group D) during compression were examined. Survival rates were compared and hematological and histologic analyses were performed at specific time points after compression release. RESULTS: Limb or whole-body warming significantly worsened the survival of rats. We found a much lower survival rate of 0%-10% in animals, in which the hindlimbs were warmed during compression (Groups C and D) at 12 h after compression release, compared with 90%-100% in animals without warming of the hindlimbs (Groups A and B). Groups C and D showed significantly enhanced hyperkalemia at ≥4 h after compression release and all blood samples from dead cases showed hyperkalemia (>10 mEq/L). CONCLUSIONS: We developed a new lethal and reproducible rat CS model with a quantitative load. This study found that warming of compressed limbs worsened the survival rate and significantly enhanced hyperkalemia, apparently leading to cardiac arrest.
BACKGROUND:Crush syndrome (CS) has been reported in disasters, terrorist incidents, and accidents, and the clinical and pathologic picture has gradually been clarified. Few lethal and reproducible animal models of CS with use of a quantitative load are available. A new model is needed to investigate pathologic and therapeutic aspects of this injury. MATERIALS AND METHODS: Using a device built from commercially available components, both hindlimbs of anesthetized rats were respectively compressed for 6 h using 3.6-kg blocks. The effects of trunk warming alone without compressed hindlimbs (Group A), non-warming at room temperature (Group B), whole-body warming including compressed hindlimbs (Group C), or warming of compressed hindlimbs alone (Group D) during compression were examined. Survival rates were compared and hematological and histologic analyses were performed at specific time points after compression release. RESULTS: Limb or whole-body warming significantly worsened the survival of rats. We found a much lower survival rate of 0%-10% in animals, in which the hindlimbs were warmed during compression (Groups C and D) at 12 h after compression release, compared with 90%-100% in animals without warming of the hindlimbs (Groups A and B). Groups C and D showed significantly enhanced hyperkalemia at ≥4 h after compression release and all blood samples from dead cases showed hyperkalemia (>10 mEq/L). CONCLUSIONS: We developed a new lethal and reproducible rat CS model with a quantitative load. This study found that warming of compressed limbs worsened the survival rate and significantly enhanced hyperkalemia, apparently leading to cardiac arrest.