Document Detail


Primary treatment of 50 patients with high-tension electrical injuries. I. Fluid resuscitation.
MedLine Citation:
PMID:  6740254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 fatal cases had ST-T abnormalities and two of these patients showed cardiac infarction at autopsy. Early angiography was performed in 20 patients (40%). Obliterated arteries were diagnosed on different levels in 18 extremities in ten patients. The arteriography very precisely indicated the level of amputation of the seriously injured extremities.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
G Arturson; A Hedlund
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of plastic and reconstructive surgery     Volume:  18     ISSN:  0036-5556     ISO Abbreviation:  Scand J Plast Reconstr Surg     Publication Date:  1984  
Date Detail:
Created Date:  1984-08-15     Completed Date:  1984-08-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0121375     Medline TA:  Scand J Plast Reconstr Surg     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  111-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amputation
Angiography
Child
Electric Injuries / complications,  therapy*
Electrocardiography
Electroencephalography
Extremities / surgery
Fascia / surgery
Fluid Therapy*
Humans
Kidney Failure, Acute / etiology,  prevention & control*
Male
Middle Aged
Myoglobin / metabolism
Time Factors
Transplantation, Autologous
Chemical
Reg. No./Substance:
0/Myoglobin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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