Crush syndrome of children in the Marmara Earthquake, Turkey

Abstract

Background: Crush syndrome is defined as traumatic rhabdomyolysis with systemic and local complications.

Methods: Crush syndrome and its related complications were diagnosed on the basis of clinical and biochemical data. In this study. we evaluated 20 children with crush syndrome transferred to our center in Bursa during the Marmara earthquake, 1999. We investigated the clinical and laboratory findings of these children.

Results: Serum creatine kinase, aspartate aminotransferase, and alanine aminotransferase levels were high in all patients. Fifty-five percent of the patients (n = 11) had one extremity injury and 45% (n = 9) had multiple extremity injuries. Fasciotomy was required in 15 children, Serum muscle enzymes and D-dimer levels were high in children with multiple extremity injuries. Acute renal failure developed in 35% (n: 7/20) of them. Peak serum creatine kinase level was positively correlated with aspartate aminotransferase, alanine aminotransferase, hospitalization time, serum urea and creatinine (P < 0.05).

Conclusions: Crush syndrome was more severe in children with multiple extremity injuries and acute renal failure frequently developed in these children. Peak serum creatine kinase level as well as potassium, urea, uric acid, creatinine, lactic dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and calcium levels were the helpful biochemical parameters in estimating the severity of crush syndrome.