ABSTRACT

Effectiveness of hyperbaric oxygen therapy in crush injury due to earthquake is not reported yet. In this study, the patients, who developed compartment syndrome as a result of crush injury after the Marmara earthquake on August 17, 1999, and who were treated with firstly decompressive fasciotomy and then hyperbaric oxygen therapy, were evaluated retrospectively.

After examination and prior treatment on admission, the patients, who had sustained injuries by being compressed under collapsed buildings, were diagnosed with the crush syndrome. On admission, arterial blood gas analysis, whole blood count, biochemical assays, and radiographic and neurological examinations were done. All patients underwent decompressive fasciotomy. Wound cultures were collected from patients and antibiotherapy was started if necessary. Wound cleanings were maintained daily and surgical debridement was performed if needed. Hyperbaric oxygen therapy was performed twice daily at 2,5 Absolute Athmosphere (ATA) by two-hour sessions in postoperative period. Total number and the duration of sessions of hyperbaric oxygen therapy were noted.

Fifty two patients were treated with hyperbaric oxygen therapy in postoperative period. Hyperbaric oxygen therapy was provided to all patients in 946 sessions, varying between 3 to 70 sessions per patient. Forty five of 52 patients were recovered without any complication or any sequels. Hemodialysis was performed to 7 patients for acute renal failure, and two of them died during the hyperbaric oxygen therapy due to acute respiratory distress syndrome and sepsis.

Hyperbaric oxygen therapy should be considered in the treatment of crush injuries due to earthquakes.