title: Response to delayed fluid therapy in crush syndrome.
abstract: BACKGROUND
  Although early treatment is valuable in the prognosis of crush syndrome, the diagnosis and treatment of many victims are inevitably delayed in major disasters.
  
  
  METHODS
  Among the 38 victims of the Marmara earthquake with crush injury, 27 were diagnosed as crush syndrome on the basis of findings of acute renal failure. Intensive intravenous fluid treatment was started in all patients on admission. Of these 27 patients, 10 required dialysis treatment while 17 did not. The laboratory data on admission were evaluated and compared between the two groups.
  
  
  RESULTS
  The mean admission time of 27 patients was 46.5 +/- (SE) 3.08 h. There was no significant difference between the dialysis and the nondialysis groups with regard to patient's age, trapped time or admission time. A significantly higher number of patients had crush injury in more than one extremity in the dialysis group. The dialysis group had significantly lower systolic blood pressure, central venous pressure but a higher heart rate together with higher levels of serum urea nitrogen, creatinine, creatinine kinase, C-reactive protein, fibrinogen on admission compared to the nondialysis group.
  
  
  CONCLUSIONS
  Our results suggest that even delayed application of aggressive specific fluid treatment under close monitoring may prevent the development of established acute renal failure.
authors.affiliation: Nephrology and Dialysis Unit, Emergency Hospital, Ankara, Turkey. aensari@ato.org.tr
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Ensari
authors.forename: Omaç
authors.initials: O
authors.lastname: Tüfekçioglu
authors.forename: Deniz
authors.initials: D
authors.lastname: Ayli
authors.forename: Tülin
authors.initials: T
authors.lastname: Gümüs
authors.forename: Seval
authors.initials: S
authors.lastname: Izdes
authors.forename: Sacit
authors.initials: S
authors.lastname: Turanli
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003404:Creatinine / Q000097:blood; D003444:Crush Syndrome / Q000628:therapy*; D004190:Disasters; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013997:Time Factors; D014421:Turkey
chemical_list: D003404:Creatinine