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Correspondence
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Volume 354:2511-2512 June 8, 2006 Number 23
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Crush-Related Injury after Disasters

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by Sever, M. S.
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To the Editor: The review of crush injuries by Sever et al. (March 9 issue)1 does not mention the hyperkalemic response to succinylcholine that is associated with these injuries.2 Crush injuries and other pathologic conditions (e.g., burns, prolonged immobilization, nondepolarizing neuromuscular blockade, and severe infection) seem to be associated with up-regulation of the acetylcholine receptor, manifested by an increased number of receptors, increased sensitivity of the receptors to agonists, and increased distribution of receptors beyond the neuromuscular junction. This results in a massive release of potassium on the administration of succinylcholine and in hyperkalemia, causing cardiac arrest.

Persons with crush . . . [Full Text of this Article]



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