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Hemoadsorption therapy for earthquake victims with crush injury

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dc.contributor.authorGÜL, FETHİ
dc.contributor.authorsKandemir E., Kutlu Ç., Bilir A., Gül F.
dc.date.accessioned2023-12-13T08:30:11Z
dc.date.available2023-12-13T08:30:11Z
dc.date.issued2023-05-07
dc.description.abstractIntroduction: Recently, a huge earthquake struck south-eastern Turkey causing the death of tens of thousands of people. In this case report, we share our experience of usage of extracorporeal hemoadsorption filter in two patients with crush injury and acute kidney injury.Case: A 59 year-old male patient was under rubble for 24 hours with his left leg trapped. The patient was transported to our hospital on the second day after the incident. At the admission, he had cardiac arrest with the rhythm of ventricular fibrillation. He was defibrillated two times and resuscitated for 30 minutes. Serum potassium, phosphorus levels were 8.5 mEq/L, 9 mg/dL respectively. Intravenous calcium,dextrose+insulin was given immediately and continuous renal replacement therapy was started. Initial creatine kinase (CK) level was 82000 U/L. He has undergone an urgent surgery for amputating his left leg which was necrotic. The day after his admission, extracorporeal hemoadsorption therapy (JAFRON-HA330) was started five hours a day for five consecutive days. CK levels gradually decreased to 60187-46852-16954-11600 U/L in daily order. Vasopressors were stopped on the third day of admission. A 32-year-old male patient had been extricated after 24 hours of entrapment. He had fifteen minutes of CPR following a cardiac arrest from hyperkalemia. Initial levels of CK, potassium, phosphorus were 72116 U/L, 6.5 mEq/L, 7.3 mg/dL respectively. CRRT with hemadsorption filter (Jafron® HA330) was started. CK levels gradually decreased to levels of 64271-35670-25441-12475-10469 U/L in daily order. He got free of vasopressors on the third day and extubated on the fourth day of admission.Discussion: Crush injury is a hyperinflammatory state with circulating cytokines causing multisystemic organ dysfunctions. Hemoadsorption techniques may adsorb molecules which potentially play a role during pathogenesis of rhabdomyolysis.The use of hemoadsorption therapy in our patients with severe traumatic rhabdomyolysis was associated with a significant reduction in plasma concentrations CK so it is a potentially attractive adjunctive treatment for this condition.
dc.identifier.citationKandemir E., Kutlu Ç., Bilir A., Gül F., \"Hemoadsorption Therapy for Earthquake Victims with Crush Injury\", 24th International Intensive Care Symposium, İstanbul, Türkiye, 5 - 06 Mayıs 2023, cilt.21, ss.28
dc.identifier.urihttps://scholar.google.com/citations?view_op=view_citation&hl=tr&user=64NEn_QAAAAJ&sortby=pubdate&citation_for_view=64NEn_QAAAAJ:Tiz5es2fbqcC
dc.identifier.urihttps://hdl.handle.net/11424/295620
dc.language.isoeng
dc.relation.ispartof24th International Intensive Care Symposium
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectTıp
dc.subjectSağlık Bilimleri
dc.subjectMedicine
dc.subjectHealth Sciences
dc.subjectKlinik Tıp (MED)
dc.subjectKlinik Tıp
dc.subjectClinical Medicine (MED)
dc.subjectCLINICAL MEDICINE
dc.subjectHemoadsorption therapy
dc.subjectearthquake
dc.subjectcrush injury
dc.subjectinflammation
dc.titleHemoadsorption therapy for earthquake victims with crush injury
dc.typeconferenceObject
dspace.entity.typePublication
local.avesis.id0897be48-bfb4-40b2-a305-06a5f98e0947
relation.isAuthorOfPublication907a6efd-2877-4832-b6a2-d87a28e52165
relation.isAuthorOfPublication.latestForDiscovery907a6efd-2877-4832-b6a2-d87a28e52165

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