TRAUMATIC RHABDOMYOLYSIS FROM SEVERE BEATING - EXPERIENCE OF VOLUME DIURESIS IN 200 PATIENTS

Authors
Citation
Jd. Knottenbelt, TRAUMATIC RHABDOMYOLYSIS FROM SEVERE BEATING - EXPERIENCE OF VOLUME DIURESIS IN 200 PATIENTS, The journal of trauma, injury, infection, and critical care, 37(2), 1994, pp. 214-219
Citations number
11
Categorie Soggetti
Emergency Medicine & Critical Care
Volume
37
Issue
2
Year of publication
1994
Pages
214 - 219
Database
ISI
SICI code
Abstract
Fluid loading with balanced salt solution (BSS) was carried out in 200 patients with extensive soft tissue injuries from severe beatings. Ur inary volume and dipstick specific gravity testing were used to monito r renal function with administration of furosemide for persistent olig uria. Acute intrinsic renal failure (AIRF) occurred in 21 patients (10 .5%) and five patients died (2.5%); two of hyperkalemia, two of sepsis and one of multiple organ failure. Significantly increased rates of A IRF and death were associated with injury-admission intervals of more than 12 hours, severe metabolic acidosis, low initial hemoglobin, heav y pigmenturia, and high serum creatine kinase (CK) levels. An increase d serum creatinine/BUN ratio was noted in four of the five patients wh o died. An average of 7.5 L fluids was needed in non-AIRF patients to achieve adequate diuresis with a mean positive fluid balance of 4.7 L. No patient without pigmenturia developed AIRF. Balance salt solution volume diuresis supplemented with furosemide as necessary appears to b e safe and effective in preventing AIRF in soft tissue injuries sustai ned in beatings.