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A patient has been trapped under a tube train below his waist for 90 minutes until he was freed.
He has arrived hypotensive and is being resuscitated.
His CK is grossly elevated and you presume he has a crush syndrome and consequent rhabdomyolysis.
This patient has crush syndrome. Which of the features of crush syndrome is usually the first to manifest?
How long can muscle be hypoxic before damage becomes permanent?
What are the pathophysiological causes of the five serious clinical sequelae of rhabdomyolysis?
Sequestration of fluid within muscle and myocytes
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Release of potassium into the systemic circulation
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Release of organic acids, phosphate and sulphate
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Nephrotoxic effects release of myoglobin, inflammatory mediators
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Consumption of clotting factors
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