IMPORTANCE OF DEFINITIVE CRITICAL CARE MEDICINE IN 2008 WEST-CHINA (WEN-CHUAN) EARTHQUAKE RELIEF

Abstract

PURPOSE: To analyze effectiveness and importance of critical ill patients resulted from Wen-Chuan earthquake. Therapies and results were summarized aiming to reference in possible future massive critical care surge capacity in natural disaster. METHODS: Critical ill patients resulted from 12nd, May 2008 West-China (Wen-Chuan) earthquake admitted to Emergency Intensive Care Unit (EICU) of Sichuan Provincial Hospital (SCPH) and therapies were retrospectively analyzed. Severity and underlied chronic illness and treatment results were summarized. RESULTS: From 12nd May 2008 to 11th June 2008, the SCPH admitted 3437 patients resulted from the earthquake. 40 earthquake severe wounded patients were admitted to the EICU of SCPH. Eighteen (45%) among them were diagnosed crush syndrome (CS) with cute renal failure (ARF). 94% (17/18) among them underwent continuous renal replacement therapy (CRRT). 5/40 (12.5%) patients underwent amputation surgery. 5/40 (12.5%) patients turned out delayed spleen rupture. 23/40 (57.5%) patients scored APACHE > 25 at admission. 11/40 (27.5%) patients were found with underlying chronic illness. 6/40 died. The average age of died patients was 65.17+/-26.98 years. The regular capacity of the EICU is 13 beds. The maximal single day patients number in the EICU is 18. The maximal single day working doctors in EICU is 18 persons (9 from SCPH and 9 reinforced from other cities). CONCLUSION: CS incidence resulted from earthquake is high. Early CRRT may finally yield survival. Mortality in patients with chronic illness turned out high. Severe wound earthquake patients needed to admitted to ICU as early as possible. ICU based multi-discipline rescuing is important in earthquake relief. CLINICAL IMPLICATIONS: Critical care surge capacity need to be estimated in regular medical practice. Capacity of both ICU settings and professionals is important for definitive care for critical ill in a natural disaster.