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Emergency Medicine Journal 2003;20:247-250; doi:10.1136/emj.20.3.247
© 2003 BMJ Publishing Group Ltd and the College of Emergency Medicine.

ORIGINAL ARTICLE

Crush syndrome patients after the Marmara earthquake

O Demirkiran, Y Dikmen, T Utku, S Urkmez

Istanbul University, Cerrahpasa Medical School, Department of Anaesthesiology, Sadi Sun ICU, Istanbul, Turkey

Correspondence to:
Correspondence to:
Dr O Demirkiran, Esekapi Kizilelma Cad no 105/3 Findikzade, Istanbul, Turkey;
odemirkiran{at}superonline.com

Background: To assess the treatment and outcome of patients with crush injury sustained in the Marmara earthquake.

Methods: Seven hundred eighty three patients were transferred to a university hospital and 25 of them were admitted to the intensive care unit. The medical records of 18 crush injury patients were retrospectively reviewed.

Results: The major associated injuries were in the lower extremities, upper extremities, and chest. Seven patients underwent fasciotomy and six patients had amputations. Twelve patients required mechanical ventilation. Adult respiratory distress syndrome developed in four patients. Oliguria occurred in eight patients. Hyperkalaemia was seen in six patients and four of them underwent emergency haemodialysis. One patient died because of hyperkalaemia on arrival to the intensive care unit. Renal failure was treated with haemodialysis or haemoperfusion in 13 patients. Five patients died because of multiple organ failure and two patients because of sepsis.

Conclusion: Crush syndrome is a life treatening event. The authors believe that early transportation and immediate intensive care therapy would have improved the survival rate.

Keywords: earthquake; crush syndrome; acute renal failure


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