Repository of Research and Investigative Information

Repository of Research and Investigative Information

Hormozgan University of Medical Sciences

Prophylactic fluid therapy in crushed victims of Bam earthquake

(2011) Prophylactic fluid therapy in crushed victims of Bam earthquake. American Journal of Emergency Medicine.

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Abstract

Background: Acute kidney injury (AKI) is a severe and preventable problem of crushed earthquake victims. Early hydration therapy started before fully removing earthquake rubbles has been claimed to play a decisive role in AKI prevention, which saves the necessity of later dialysis. However, the extent, quality, and appropriateness of its know-how are controversial. Methods: Processing clinical and paraclinical data gathered from Bam earthquake victims older than 15 years, we tried to determine correlations between the time of being under the rubbles (TUR), the level of serum creatine phosphokinase (CPK), the delayed onset of fluid therapy (DFT), and finally the volume of intravenous fluid received per day (VFR) with the formation of AKI and the need for dialysis. Results: There is a direct and significant relation between the intensity of the trauma (TUR and CPK) and DFT with the occurrence of AKI and need for dialysis (P <.001). However, as the VFR increases, the occurrence of AKI and the need for dialysis significantly decrease (P =.005). Based on multivariate analysis, the occurrence of AKI and the need for dialysis are primarily affected by CPK, TUR, and VFR; and DFT has been dropped out. The analysis showed the preventive role of VFR more than 6 L in severe rhabdomyolysis patients and of at least 3 L in moderate ones in development of AKI and dialysis. Conclusions: In the severely rhabdomyolized patients (CPK ≥15 000), higher volumes of prophylactic fluid (VFR >6 L) are required, whereas in less-traumatized patients, lower volumes (3-6 L) would be effective. © 2011 Elsevier Inc.

Item Type: Article
Additional Information: cited By 11
Keywords: creatine kinase; infusion fluid, acute kidney failure; article; creatine kinase blood level; dialysis; earthquake; female; fluid therapy; human; major clinical study; male; multivariate analysis; priority journal; prophylaxis; time; victim, Acute Kidney Injury; Chi-Square Distribution; Confidence Intervals; Creatine Kinase; Crush Syndrome; Disasters; Earthquakes; Female; Fluid Therapy; Humans; Iran; Logistic Models; Male; Odds Ratio; Renal Dialysis; Risk Factors; Time Factors
Subjects: WA Public Health > WA 108-245 Preventive Medicine
Depositing User: مهندس هدی فهیم پور
URI: http://eprints.hums.ac.ir/id/eprint/5369

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