EARTHQUAKE KNOWLEDGE UPDATE

EARTHQUAKE KNOWLEDGE UPDATEkapak

PATIENT MANAGEMENT IN INTENSIVE CARE UNIT

Ayşegül Aksoy1 Ayşe Mızrak2

1Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Department of Medical Biochemistry, İstanbul, Türkiye
2Gaziantep University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Gaziantep, Türkiye

Aksoy A, Mızrak A. Patient Management in Intensive Care Unit. In: Kalenderer Ö, Servet E, editors. Earthquake Knowledge Update. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.57-70.

ABSTRACT

Natural disasters have repeatedly affected our world throughout history, leading to significant morbidity and mortality. Major earthquakes are some of the most devastating natural disasters. Earthquakes frequently affect densely populated urban areas with poor structural standards. They often result in high death rates and mass casualties with many traumatic injuries. Earthquakes cause not only physical damage but also a variety of clinical complications in affected individuals. One of the most notable conditions observed in intensive care unit (ICU) patients following earthquakes is crush syndrome (CS). Crush syndrome is characterized by traumatic rhabdomyolysis, hypotension from reduced intravascular volume, hyperkalemia, and acute renal failure, typically due to hypovolemia. During rhabdomyolysis, intracellular components, including potassium, phosphorus, nucleic acids, and myoglobin, are released into the circulation, contributing to systemic toxicity. Among laboratory findings, hyperkalemia is often the most critical and life-threatening. Secondary complications related to rhabdomyolysis may include acute renal failure, compartment syndrome, disseminated intravascular coagulation (DIC), and a spectrum of metabolic disturbances. In addition, patients with CS are at risk of developing pulmonary complications, infections, and other systemic medical issues. Early intervention at the injury site—before hospital admission—is essential. Continuous monitoring and comprehensive management in the ICU, preferably through a multidisciplinary approach, are vital for reducing mortality and morbidity associated with crush syndrome following earthquakes.

Keywords: Earthquake; Crush syndrome; Intensive care units; Patient care management; Mortality

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