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[Diseases of the shipwrecked: apropos of 3 cases]
J M Dalger1, C Belat, C Le Marec
1Service d'Anesthésie-Réanimation, H.I.A. Clermont Tonnerre, Brest Naval.
Insights
Rescued shipwreck survivors experienced severe biological disorders, including dehydration and organ damage, despite appearing stable. Prompt intensive care unit (ICU) management and rehydration are crucial for recovery.
Area of Science:
- Emergency Medicine
- Toxicology
- Nephrology
Background:
- Shipwreck incidents pose significant risks to survivors, often leading to severe physiological stress.
- Understanding the pathophysiology of prolonged exposure and deprivation is critical for effective medical intervention.
Observation:
- Three adult males rescued after 50 hours adrift presented with multiple bruises, dehydration, and epigastric pain.
- Despite a non-alarming initial clinical appearance, all survivors exhibited severe biological abnormalities.
Findings:
- Key findings included hemoconcentration, functional renal insufficiency, metabolic acidosis, severe rhabdomyolysis, and hepatic cytolysis.
- Intravenous rehydration over 24 hours successfully corrected hydroelectrolytic and acid-base imbalances.
Implications:
- Immediate intensive care unit (ICU) admission is essential for shipwreck survivors.
- The psychological and emotional well-being of survivors must be addressed alongside physical recovery.
Abstract:
Three men (31, 34, 36 yr old) were rescued after they had drifted for 50 hours on their wrecked catamaran. While their apparent clinical condition was not worrying, besides multiple bruises, marked dehydration, epigastralgias, mild hypothermia in one patient and 50, severe biological disorders were present in all four: haemoconcentration, functional renal insufficiency, metabolic acidosis, severe rhabdomyolysis, hepatic cytolysis. After intravenous rehydration for 24 hr hydroelectrolytic and acid-base anomalies were corrected. Pathophysiology of shipwreck casualties is recalled. Initial management in ICU is necessary. Psychological and emotional aspects should not be underrated.