Korean Journal of Nephrology 1997;16(2):391-397.

건축물 붕괴사고로 인한 장기매몰 환자의 임상양상

김상일 , 조성원 , 김영옥 , 박철휘 , 윤성노 , 양철우 , 진동찬 , 장윤식 , 방병기

Abstract

Following the department store building collapse disaster on June 29, 1995, more than 140 people were brought to emergency care center of the Catholic medical center. Among them three starvated people due to long term confined in the collapsed building and one severe crush injured patient deve- loped to prerenal azotemia and ARF. Case 1, 21- year-old man had been confined in the collapsed building debris for 11 days, he had been able to drink water and showed only mild dehydration on admission. Case 2, 3, 18-year-old woman and 19- year-old woman had been confined for 13 and 17 days even without water intake. They were severely dehydrated, hypotensive and hypernatremia on admission. Case 4, 39-year-old man was crushed by bui- 1ding debris and rescued 22 hours later and was diagnosed as ARF due to traumatic rhabdomyolysis. Case 1, 2 and 3 improved immediately only with fluid therapy. Case 4 progressed to acute tubular necrosis, in spite of therapy, and required hemodialysis. Severe dehydration due to long term starvation in young healthy person over 17 days did not progressed to acute tubular necrosis only with adequate fluid therapy. To prevent acute tubular necrosis in crush injured patient, needs more immediate and intensive fluid therapy at the rescue and careful correction of hypernatremia.