Primary treatment of 50 patients with high-tension electrical injuries. I. Fluid resuscitation
Scandinavian Journal of Plastic and Reconstructive Surgery
G Arturson, A Hedlund
Fifty patients with high-tension electrical injuries referred for primary treatment to the Burn Center at the University of Uppsala, Sweden during the period 1969 to 1982, have been investigated with special regard to the resuscitation and early complications from internal organs. Seven patients (14%) died, five of them prior to 1974, one in cardiac infarction and four in renal failure. Two died after 1974, one in cardiac infarction and the other in severe shock (98% burn). In 1974 an acute intensive prevention of renal failure was instituted based on forced fluid resuscitation, vasodilators, and supply of alkaline solutions in order to avoid myoglobin and hemoglobin casts in the kidneys. Some degree of renal dysfunction (diminished GFR, a lowered concentration capacity, and an increased fractionate excretion of sodium) was often seen but could usually be reversed without problems. Three patients who developed anuria were successfully treated with hemodialysis. During the years 1974-1982, when the "prevention scheme of renal failure" was applied, all patients with high-tension electrical injury combined with severe myoglobinuria (13 patients) have been successfully treated. 60% of the patients had normal ECG. Five of the seven ...Continue Reading
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Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut