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地震灾害后危重症患者的管理

Management of critically ill patients following earthquake disasters.

作者信息

Kaya Esat Kıvanç, Halaçli Burçin, Yildirim Mehmet, Topeli Arzu

机构信息

Division of Intensive Care Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkiye.

出版信息

Turk J Med Sci. 2025 Apr 22;55(4):813-825. doi: 10.55730/1300-0144.6033. eCollection 2025.

Abstract

The devastating earthquakes that struck southeastern Türkiye on February 6, 2023, underscored the profound social and healthcare challenges of large-scale natural disasters. These events highlighted the need for healthcare professionals to be well-prepared and equipped with the expertise to manage such crises effectively. Earthquake-induced trauma presents a wide array of medical and surgical complications, frequently requiring urgent hospitalization and specialized management for critically ill patients. However, the limited availability of comprehensive data and evidence-based guidelines complicates optimal care delivery in these scenarios. This review outlines current recommendations for the multidisciplinary management of critically ill patients with earthquake-related trauma. It underscores the significance of promptly identifying and addressing acute complications, including crush syndrome, acute kidney injury, infections, and sepsis. Key strategies such as individualized fluid and electrolyte management, nutritional interventions, and rigorous infection control measures are discussed. Additionally, this review highlights the critical roles of physiotherapy and psychological support in the rehabilitation process, as well as the importance of long-term follow-up for survivors at risk of postintensive care syndrome and posttraumatic stress disorder. To enhance future disaster response and patient outcomes, the review calls for strengthened collaboration, preparedness, and research efforts. This comprehensive examination provides a framework for managing critically ill patients hospitalized due to earthquake-related trauma, offering valuable insights for healthcare providers across multiple disciplines.

摘要

2023年2月6日袭击土耳其东南部的毁灭性地震凸显了大规模自然灾害带来的深刻社会和医疗挑战。这些事件凸显了医疗保健专业人员做好充分准备并具备有效应对此类危机的专业知识的必要性。地震引发的创伤会带来一系列医学和外科并发症,重症患者常常需要紧急住院治疗和专业管理。然而,全面数据和循证指南的可用性有限,使得在这些情况下提供最佳护理变得复杂。本综述概述了对地震相关创伤重症患者进行多学科管理的当前建议。它强调了及时识别和处理急性并发症的重要性,包括挤压综合征、急性肾损伤、感染和脓毒症。讨论了个体化液体和电解质管理、营养干预以及严格的感染控制措施等关键策略。此外,本综述强调了物理治疗和心理支持在康复过程中的关键作用,以及对有重症监护后综合征和创伤后应激障碍风险的幸存者进行长期随访的重要性。为了加强未来的灾害应对和改善患者预后,该综述呼吁加强合作、做好准备并加大研究力度。这一全面审视为管理因地震相关创伤而住院的重症患者提供了一个框架,为多个学科的医疗保健提供者提供了宝贵的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9881/12419051/8ccc4f8e9c98/tjmed-55-04-813f1.jpg

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