Türk Nöroşirürji Dergisi 2023 , Vol 33 , Num 2
Management of Intensive Care Patients in Earthquake; Crush Syndrome and Thorax Trauma
1Başkent Üniversitesi, Adana Dr. Turgut Noyan Uygulama ve Araştırma Merkezi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yoğun Bakım Bilim Dalı, Adana, Türkiye Crush syndrome is frequent following natural disasters or events of war and terrorism. Traumatic rhabdomyolysis is manifested by severe metabolic disturbances such as myoglobinuric acute kidney injury, electrolyte disturbances, and cardiovascular collapse. Muscle tissue contains a variety of electrolytes and enzymes that can reach toxic levels when circulating in excessive amounts. Hypovolemic shock develops with the passage of sodium, calcium, and fluids into the extravascular space due to regional ischemia. Crush syndrome can also lead to cardiovascular instability and renal failure due to vasomotor and nephrotoxic factors. Diagnostic investigations usually involve evaluation of serum levels of myoglobin and myoglobin degradation products. Treatment of crush syndrome requires a multidisciplinary approach that addresses the metabolic, cardiovascular, and renal complications associated with this condition. The mainstay of treatment includes early intervention for the affected limb or compartment, fluid resuscitation, correction of electrolyte abnormalities, and alkalinization of the urine. In addition, renal replacement therapy and hyperbaric oxygen therapy may be beneficial in the management of acute kidney injury and tissue hypoxia, respectively. Early recognition and appropriate management can significantly reduce the morbidity and mortality associated with Crush syndrome. Anahtar Kelimeler : Crush syndrome, Earthquake, Thorax trauma