The Crush Syndrome (and Lessons Learned from the Marmara Earthquake)

ARF induced by traumatic rhabdomyolysis and crush syndrome is a well-known complication occurring in the wake of natural or manmade disasters. As a matter of fact, it is the second most frequent cause of death, following the direct traumatic impact. Early recognition of the crush syndrome and rapid initiation of fluid replacement is essential as this can dramatically reduce the incidence of ARF. After the Marmara earthquake of 1999, the Turkish Society of Nephrology, in collaboration with the Renal Disaster Relief Task Force of the International Society of Nephrology, prepared special questionnaires to obtain patient data and follow-up information to analyze the extent of the nephrological problems. This book is based on the 639 cases consequently documented, constituting an unprecedented collection of first-hand experience on crush syndrome-related ARF following earthquakes. In addition to the data / analysis gained from the Marmara earthquake, each chapter also summarizes classical information on crush syndrome. In every major natural catastrophe, a rapid, appropriate and effective international response is essential to minimize losses and be able to adequately treat victims. This can be achieved only by rational planning and the establishment of an infrastructure composed of trained personnel, equipment, supplies and transportation that can be mobilized at a few hours' notice is essential. This book has been written with the intent to make use of the experiences made after the Marmara earthquake to save more lives in similar future disasters.