Analysis of 372 Patients with Crush Syndrome Caused by the Hanshin-Awaji Earthquake

Abstract

Peak serum concentration of creatine kinase as well as the number of injured extremities serve to estimate the severity of crush syndrome.

The Chinese national emergency medical rescue team response to the Sichuan Lushan earthquake

“…The incidence probably higher than that we observed. In other studies, the incidence of Crush syndrome rages from 3.9 to 5.4 % Oda et al 1997).…”

Effect of Fluid Therapy on Prevention of Acute Renal Failure in Bam Earthquake Crush Victims

“…[14,15] • Crush syndrome was defined in patients as crush injury with systemic manifestations. [10] • Patients with crush injury and either oliguria (urinary output <400 mL/d), elevated levels of BUN (>40 mg/ dL), or serum creatinine (>2.0 mg/dL) were considered as patients with renal impairment.…”

“…[9] Moreover the pressure causes necrosis of the muscle, and during revascularization, the diffusion of calcium, sodium, and water into the damaged muscle cellstogether with the loss of potassium, phosphate, lactic acid, myoglobin, and creatinine kinase-can lead to hyperkaliemia and acidosis. [10][11][12][13][14] Thus, the renal problems due to pressure-induced rhabdomyolysis have been claimed to carry unique laboratory features as compared to other causes of ARF, such as increased serum levels of muscle enzymes and a higher ratio of creatinine/blood urea nitrogen (BUN), as well as higher degrees of uricemia, phosphatemia and, most importantly, life-threatening hyperkaliemia. [8] When these laboratory abnormalities come together with a high incidence of surgical and medical complications, [13] calculated mortality rates of up to 40% in dialyzed patients can be expected.…”

“…[8] When these laboratory abnormalities come together with a high incidence of surgical and medical complications, [13] calculated mortality rates of up to 40% in dialyzed patients can be expected. [10,14] The management of renal failure in these settings is early, aggressive, and generous fluid replacement, which has been suggested as the most effective method for preventing ARF related to crush syndrome. However, if this treatment is inadequate or delayed for more than 6 hr, ARF is almost inevitable.…”

“…However, if this treatment is inadequate or delayed for more than 6 hr, ARF is almost inevitable. [10][11][12][13][14][15] In the morning of December 26, 2003, at 5:28 a.m. (local time), a major earthquake measuring 6.5 on the Richter scale struck the city of Bam, Kerman Province, southeastern Iran. According to seismologists, the earthquake is one of the shallowest recorded, with a focal epicenter directly underneath the Bam city.…”