102

Friday, March 29, 1985

THE DETROIT, JEWISH

:

NEWS

Curing Crush Syndrome

Technion doctors make breakthrough.

Remember the
11th Commandment:

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"And Thou
Shalt be
Informed"

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Emergency medical teams from Technion-Israel Institute of
Technology and Rambam Hospital administer medication to victims of
"crush syndrome" at the site of the Tyre explosion.

- N

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On Nov. 13, 1982, the seven-
story building which housed the
Israeli Army Headquarters in
Tyre, Lebanon was rocked by a
violent explosion instantly
entombing the soldiers inside.
Out of this tragic incident came a
medical breakthrough benefitt-
ing victims of "crush syndrome."
Soldiers trapped under fallen
masonry, as well as victims of a
coal mine collapse or an auto-
mobile mishap, have their mus-
cles exposed to prolonged, exten-
sive pressure. Crush syndrome
occurs when a substance called
myoglobin leaks out of the dam-
aged muscles and forms plugs in
the kidneys, precipitating their
failure and ultimately the death
of the victim.
Crush syndrome was first
documented by English physi-
cians during World War II when
treating civilians caught in the
wreckage of German bombing
raids on London. With informa-
tion derived from laboratory ani-
mals, a variety of theories for the
treatment of crush syndrome
were developed but remained un-
tested because kidney failure
usually was established by the
time its human victims reached
proper medical facilities. It took
the tragedy at Tyre for medical
teams from the Technion to per-
fect an effective treatment for
crush syndrome.
Among their findings, pub-
lished in the Feb. 1984 issue of
Archives of Internal Medicine,

was that the victims of crush syn-
drome were not in danger of kid-
ney failure while still buried.
Myoglobin from damaged muscles
didn't begin leaking until after
external pressure was relieved
and that infusion of fluids to pro-
tect the kidney was still possible
for victims buried for long periods
of time. Two of the Tyre victims
were buried longer than 24 hours.
"Each was treated using high
fluid rates," comments Prof. Shi-
mon Burzstein, vice-dean of the
Technion's medical faculty and
head of Rambam's Critical Care
Unit, "and each lived."
In addition, the emergency
medical team's report endorsed
the early infusion of fluids to pre-
vent a rapid fall in blood pressure
and found it safe to protect the
kidneys using a solution of bicar-
bonate to alkalize the blood, a pro-
cedure which had been previously
thought to be unadvisable. It was
also found that the use of certain
diuretics and the infusion of cal-
cium did not prevent kidney dam-
age in cases of crush syndrome.
With the insights which the
Technion medical team gleaned
from the tragic incident at Tyre,
other lives could benefit. "As a re-
sult of our experience," says Dr.
Ori Better, dean of the Technion's
medical school, "we came to con-
clusions regarding many nagging
questions about military
medicine. I am confident that
others will gain from our find-
ings."