ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Preventive Nephrology In Natural Disasters
Dr. F. Fevzi ERSOYa
aNefroloji BD, Akdeniz Üniversitesi Tıp Fakültesi, ANTALYA
In natural disasters, especially in earthquakes and other disasters creating trauma injuries the aim of preventive nephrology is preventing crush injury related acute renal failure. Most important tool in accomplishing that goal is preventive fluid administration . In order to maintain a sufficient renal blood flow three factors should be taken into the condideration: Cardiac output, intravascular volume, renal perfusion pressure. In crush injuries, deprivation from water, fluid and blood losses, and fluid shift from intravascular compartment towards third spaces such as peritoneum, muscle tissue, and pleural spaces is an expected process. Therefore, in disaster victims bearing the risk of acute renal failure development, fluid status should be monitored closely and hypovolemic shock and rhabdomyolysis related acute renal failure should be prevented. Saline as a fluid is generally will be enough for accomplishing that goal.In the beginning, 1-1.5 L saline per hour should be started, in case of being unsuccessful, need for further fluids should be reevaluated. Mannitol -Alkali solution has some extra advantages over saline such as treating metabolic acidosis, alkalinization of urine, treatment and prevention of cerebral and other tissue edema and inducing diuresis.Keywords: Nephrology, book reviewsTurkiye Klinikleri J Int Med Sci 2007, 3(38):110-114
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