Successful treatment of crush syndrome complicated with multiple organ dysfunction syndrome using hybrid continuous renal replacement therapy.

BACKGROUND

The M8.1 'Wenchuan' earthquake occurred on May 12th 2008 causing many injuries and casualties. We report a case with crush syndrome and multiple organ dysfunction syndrome (MODS) successfully treated with hybrid continuous renal replacement therapy (CRRT).

METHOD

The patient is a 16-year-old female who was rescued from a collapsed building after 17 h. Emergency amputation was performed. Infections and crush syndrome caused sepsis, acute respiratory distress syndrome, acute renal failure, heart failure, liver dysfunction and disseminated intravascular coagulation in a short time. Hybrid CRRT including high volume hemofiltration, low temperature blood purification, hemoperfusion using endotoxin adsorbent as well as plasmapheresis was performed.

RESULT

After the hybrid CRRT treatment, the patient's condition improved progressively. Functions of lung, heart, liver and kidney recovered. Sepsis was controlled. CRRT treatment continued for 550 h without stop. She was followed up for 6 months without any sign of residual organ dysfunction.

CONCLUSION

Hybrid CRRT is an effective treatment for patients with severe crush syndrome complicated with MODS.