Prevention of Acute Renal Failure in Traumatic Rhabdomyolysis

doi:10.1001/archinte.1984.00350140077012

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Vol. 144 No. 2, February 1984

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Prevention of Acute Renal Failure in Traumatic Rhabdomyolysis

David Ron, MD; Uri Taitelman, MD; Moshe Michaelson, MD; Gad Bar-Joseph, MD; Simon Bursztein, MD; Ori S. Better, MD

Arch Intern Med. 1984;144(2):277-280.

Abstract

• Following the collapse of a building, seven subjects(aged 18 to 41 years) were released from under the rubble withinone to 28 hours. All seven suffered from extensive crush injurieswith evidence of severe rhabdomyolysis and were treated by theinduction of an alkaline solute diuresis immediately on theirextrication from the debris. The leakage of muscle constituentswas estimated by quantifying the net total body potassium losses,which averaged 395 mEq (SD, ±198) over the first 60 hoursof therapy. In the past, injuries of similar severity have beenassociated with a high incidence of acute renal failure anda high mortality rate, yet none of our patients had azotemiaor renal failure. We attribute this success to the unprecedentedearly institution of appropriate therapy.

(Arch Intern Med 1984;144:277-280)

Author Affiliations

From the Intensive Care Unit (Drs Ron, Michaelson, Bar-Joseph, and Bursztein), the Department of Nephrology (Dr Better), and the Toxicology Unit (Dr Taitelman), Rambam Hospital, and the Technion School of Medicine (Drs Taitelman, Bursztein, and Better), Bat Galim, Haifa, Israel.

Footnotes

Accepted for publication June 30, 1983.

Reprint requests to Technion School of Medicine, 12 HaaliyahSt, Haifa 31096, Israel (Dr Better).

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