Prevention of Crush Syndrome through Aggressive Early Resuscitation: Clinical Case in a Buried Worker
Journal
Prehospital and Disaster Medicine
ISSN
1049-023X
1945-1938
Date Issued
2016
Author(s)
Alvaro Mardones
Pablo Arellano
Carlos Rojas
Rodrigo Gutierrez
Nicolas Oliver
Vincenzo Borgna
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:title>Abstract</jats:title><jats:sec id="S1049023X16000327_abs1" sec-type="intro"><jats:title>Introduction</jats:title><jats:p>Crush syndrome, of which little is known, occurs as a result of compression injury to the muscles. This syndrome is characterized by systemic manifestations such as acute kidney injury (AKI), hypovolemic shock, and hydroelectrolytic variations. This pathology presents high morbidity and mortality if not managed aggressively by prehospital care.</jats:p></jats:sec><jats:sec id="S1049023X16000327_abs2" sec-type="general"><jats:title>Clinical Case</jats:title><jats:p>A 40-year-old worker was rescued after being buried underground in a ditch for 19 hours. The patient was administered early resuscitation with isotonic solutions and monitored during the entire rescue operation. Despite having increased plasma levels of total creatine kinase (CK), the patient did not develop AKI or hydroelectrolytic variations.</jats:p></jats:sec><jats:sec id="S1049023X16000327_abs3" sec-type="conclusion"><jats:title>Conclusion</jats:title><jats:p>Aggressive early management with isotonic solutions before hospital arrival is an effective option for nephron-protection and prevention of crush syndrome.</jats:p><jats:p><jats:mixed-citation id="S1049023X16000327_refa1" publication-type="other"><jats:name name-style="western"><jats:surname>Mardones</jats:surname><jats:given-names>A</jats:given-names></jats:name>, <jats:name name-style="western"><jats:surname>Arellano</jats:surname><jats:given-names>P</jats:given-names></jats:name>, <jats:name name-style="western"><jats:surname>Rojas</jats:surname><jats:given-names>C</jats:given-names></jats:name>, <jats:name name-style="western"><jats:surname>Gutierrez</jats:surname><jats:given-names>R</jats:given-names></jats:name>, <jats:name name-style="western"><jats:surname>Oliver</jats:surname><jats:given-names>N</jats:given-names></jats:name>, <jats:name name-style="western"><jats:surname>Borgna</jats:surname><jats:given-names>V</jats:given-names></jats:name>. <jats:article-title>Prevention of crush syndrome through aggressive early resuscitation: clinical case in a buried worker</jats:article-title>. <jats:source>Prehosp Disaster Med</jats:source>. <jats:year>2016</jats:year>;<jats:volume>31</jats:volume>(<jats:issue>3</jats:issue>):<jats:fpage>340</jats:fpage>–<jats:lpage>342</jats:lpage>.</jats:mixed-citation></jats:p></jats:sec>
Subjects
acute kidney injury
;
crush syndrome
;
rhabdomyolysis