Open Access Open Access  Restricted Access Subscription or Fee Access

The need for blood products in patients with crush syndrome

Rumeyza Kazancioglu, MD, Binnur Pinarbasi, MD, Bahar Artim Esen, MD, Aydin Turkmen, MD, Mehmet S. Sever, MD

Abstract


Objectives: Crush syndrome is typical for multisystem involvement because of coexisting major surgical and/or medical problems. Treatment of patients with crush syndrome following mass disasters is even more problematic as hundreds of patients are admitted to hospitals and need therapy at once. In this study, the authors evaluated the need of blood and blood products in patients hospitalized due to crush syndrome after the Marmara earthquake in a single center.
Methods: The clinical and laboratory variables regarding 60 patients with crush syndrome (30 males and 30 females; mean age: 31.3 _ 13.8 years) hospitalized at a tertiary center that were documented on the preformed questionnaires distributed by International Society of Nephrology Task Force at the aftermath of the earthquake were analyzed by Statistical Package for Social Sciences for Windows software version 13.0 (SPSS Inc, Chicago, IL, USA).
Results: Thirty-nine patients (16 males and 23 females; mean age: 30.1 _ 12.6 years) were transfused with 589 U of blood, 840 U of fresh frozen plasma, and 172 U of human albumin during the hospitalization. Most of the transfusions were performed during the first week after the hospitalization.
Conclusions: As a result, the preparation for disasters should also include logistic plans for obtaining sufficient amount of blood and blood products to be used in the early aftermath of the event.


Keywords


-

Full Text:

PDF

References


Alexander D: The health effects of earthquakes in the mid-1990s. Disasters. 1996; 20(3): 231-247.

Bywaters EGL: Fifty years on: The crush syndrome. Br Med J. 1990; 301(6766): 1412-1415.

Better OS, Rubinstein I, Winaver J: Recent insights into the pathogenesis and early management of the crush syndrome. Semin Nephrol. 1992; 12(2): 217-222.

Sever MS,Vanholder R, Lameire N: Management of crush-related injuries after disasters. N Engl J Med. 2006; 354(10): 1052-1063.

Oda J, Tanaka H, Yoshioka T, et al.: Analysis of 372 patients with crush syndrome caused by the Hanshin-Awaji earthquake. J Trauma Injury Infect Crit Care. 1997; 42(3): 470-475.

Sever MS, Erek E, Vanholder R, et al.: Clinical findings in the renal victims of a catastrophic disaster: The Marmara earthquake. Nephrol Dial Transplant. 2002; 17(11): 1942-1949.

Kazancioglu R, Korular D, Sever MS, et al.: The outcome of patients presenting with crush syndrome after the Marmara earthquake. Int J Artif Organs. 2001; 24(1): 17-21.

Sanchez-Carrillo CI: Morbidity following Mexico City’s 1985 earthquakes: Clinical and epidemiologic findings from hospitals and emergency units. Public Health Rep. 1989; 104(5): 482-488.

Better OS: Acute renal failure in casualties of mass disasters. Kidney Int. 1993; 41: S235-S236.

Sever MS, Erek E,Vanholder R, et al.: Treatment modalities and outcome of the renal victims of the Marmara earthquake. Nephron. 2002; 92(1): 64-71.

Schmidt PJ: Blood and disaster-supply and demand. N Engl J Med. 2002; 346(8): 617-620.

Sever MS, Lameire N, Vanholder R: Renal disaster relief: From theory to practice. Nephrol Dial Transplant. 2009; 24(6): 1730-1735.

National Crisis Committee: Earthquakes, 1999. Ankara National Crisis Committee, 2000 (in Turkish).

Sever MS, Erek E,Vanholder R, et al.: The Marmara earthquake: Epidemiological analysis of the victims with nephrological problems. Kidney Int. 2001; 60(3): 1114-1123.

Sever MS, Erek E,Vanholder R, et al.: Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake. Kidney Int. 2002; 62(6): 2264-2271.

Sever MS, Erek E,Vanholder R, et al.: The Marmara earthquake: Admission laboratory features of patients with nephrological problems. Nephrol Dial Transplant. 2002; 17(6): 1025-1031.

Crosson JT: Massive transfusion. Clin Lab Med. 1996; 16(4): 873-882.

Mujeeb SA, Jaffery SH: Emergency blood transfusion services after the 2005 earthquake in Pakistan. Emerg Med J. 2007; 24(1): 22-24.

Hess JR, Thomas MJG: Blood use in war and disaster: Lessons from the past century. Transfusion. 2003; 43(11): 1622-1633.

Abolghasemi H, Radfar MH, Tabatabaee M, et al.: Revisiting blood transfusion preparedness: Experience from the Bam earthquake response. Prehospital Disaster Med. 2008; 23(5): 391-394.

Li Z,Wang W, Chen T: Blood transfusion therapy for 41 earthquake casualties. Transfus Apheresis Sci. 2009; 41(3): 179-181.

Gunal AI, Celiker H, Dogukan A, et al.: Early and vigorous fluid resuscitation prevents acute renal failure in the crush victims of catastrophic earthquakes. J Am Soc Nephrol. 2004; 15(7): 1862-1867.

Whittaker R, Fareed D, Green P, et al.: Earthquake disaster in Nicaragua. J Trauma. 1974; 14(1): 37-43.

Vanholder R, Sever MS, De Smet M, et al.: The intervention of the Renal Disaster Relief Task Force in the north-west Turkey Marmara earthquake. Kidney Int. 2001; 59(2): 783-791.

Smith HM, Farrow SJ,Ackerman JD, et al.: Cardiac arrests associated with hyperkalemia during red blood cell transfusion: A case series. Anesth Analg. 2008; 106(4): 1062-1069.

Sever MS, Erek E, Vanholder R, et al.: Serum potassium in the crush syndrome victims of the Marmara disaster. Clin Nephrol. 2003; 59(5): 326-333.

World Health Organization (eds.): Screening Donated Blood for Transfusion-Transmissible Infections: Recommendations. France: WHO Press, 2010: 1-66.

Dizer U, Demirpek U: Blood supply in pandemics. Turk J Infect. 2009; 23(1): 29-34 (in Turkish).

Glynn SA, Kleinman SH, Schreiber GB, et al.: Effect of a national disaster on blood supply and safety. JAMA. 2003; 289(17): 2246-2253.

Khan S, Rai MA, Khan A, et al.: Prevalence of HCV and HIV infections in 2005-earthquake-affected areas of Pakistan. BMC Infect Dis. 2008; 8(27): 147.




DOI: https://doi.org/10.5055/ajdm.2010.0035

Refbacks

  • There are currently no refbacks.