Clinical study on the effect of blood purification on crush syndrome. An Analysis of 23 cases caused by the Great Hanshin Earthquake.

DOI 4 Citations 12 References
  • Shigemoto Tatsuhiro
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Rinka Hiroshi
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Matsuo Yoshiro
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Kaji Arito
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Tsukioka Kazuma
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Ukai Takashi
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Shimaoka Hideki
    Intensive Care Unit, Osaka City General Hospital

Bibliographic Information

Other Title
  • クラッシュシンドロームにおける血液浄化法の臨床的検討　阪神大震災２３例の分析から
  • An Analysis of 23 Cases Caused by the Great Hanshin Earthquake
  • 阪神大震災23例の分析から

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The Great Hanshin Earthquake resulted in more than 300 cases of severe crush syndrome cases, of which 23 were transferred to our medical center within the first three days from several hospitals located in the disaster area. Taking the urine output, circulatory status and laboratory date (serum potassium and creatinine) of the patients into account, we treated them by several methods including hemodialysis (HD), continuous hemodialysis (CHD) and plasma exchange (PE). Based on the clearance of myoglobin and the time of convalescence from acute renal failure, the effectiveness of different methods of blood purification was evaluated. No patients died, or suffered renal failure after two months. The duration of blood purification was significantly correlated with the initial level of serum myoglobin, CK and AST on admission. Although the amount of myoglobin eliminated by CHD in 24 hours was larger than that by single PE, serum myoglobin level decreased linearly regardless of the methods of blood purification used. Metabolism and extraction of myoglobin released into the blood might have found alternative pathways in addition to the kidneys. Therefore, once acute renal failure has developed, the method employed for blood purification should be selected from the point of view of treating acute renal failure, rather than the elimination of myoglobin.

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