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Response to delayed fluid therapy in crush syndrome
Cüneyt Ensari1, Omaç Tüfekçioglu, Deniz Ayli
1Nephrology and Dialysis Unit, Emergency Hospital, Ankara, Turkey. aensari@ato.org.tr
Nephron
|October 26, 2002
Summary
Aggressive fluid treatment for crush syndrome, even when delayed, can prevent acute renal failure. This approach is crucial for managing victims in mass disaster scenarios.
Area of Science:
- Emergency Medicine
- Nephrology
- Trauma Surgery
Background:
- Crush syndrome diagnosis and treatment are often delayed in mass disasters.
- Early intervention is critical for improving patient prognosis.
Purpose of the Study:
- To evaluate the effectiveness of intensive intravenous fluid treatment in patients with crush syndrome following the Marmara earthquake.
- To compare outcomes between patients requiring dialysis and those who did not.
Main Methods:
- Retrospective analysis of 38 crush injury victims from the Marmara earthquake.
- 27 patients diagnosed with crush syndrome received intensive intravenous fluid treatment.
- Laboratory data on admission were compared between dialysis and non-dialysis groups.
Main Results:
- No significant differences in age, trapped time, or admission time between groups.
- Dialysis group had more multi-extremity crush injuries.
- Dialysis group showed lower blood pressure and central venous pressure, but higher heart rate and elevated serum markers (urea nitrogen, creatinine, CK, CRP, fibrinogen).
Conclusions:
- Delayed, aggressive fluid resuscitation can prevent established acute renal failure in crush syndrome.
- Close monitoring is essential during treatment.