Crush Syndrome and the Kidney.
—A number of timely and exceptionally important articles dealing with the effect on the kidney of trauma to other parts of the body have recently appeared.Bywaters1 states that in a typical case in which the patient is severely injured and has a history of, for instance, being buried for several hours with masonry resting across a limb, such a patient will be shocked on admission or soon after, with a decrease in blood pressure which follows a preliminary period of apparent well-being. During this initial phase hemoconcentration occurs (and compensatory vasoconstriction) because of loss of plasma into the injured part, which becomes swollen and hard. There is also loss of sensation and power; the skin shows whealing and, later, blisters. Arterial pulsation distally may be impaired. After restoration of blood volume by the transfusion of blood or serum the patient recovers, but