Josep Trueta (1897-1977): military surgeon and pioneer investigator of acute renal failure.

The great Spanish military and orthopedic surgeon J. Trueta gained his field and clinical experience in the Spanish civil war (1936-1939) and in Britain during World War II. As part of his major contribution to traumatology, he searched for the causes of the characteristic oliguria of combat casualties.

Management of shock and acute renal failure in casualties suffering from the crush syndrome.

Widespread muscle crush injury is often associated with profound hemodynamic shock and myoglobinuric acute renal failure (ARF). The main reason for the shock is rapid uptake by the injured muscles of a substantial portion of extracellular fluid. The shock is aggravated by NO-dependent vasodilation in the injured muscles and by hyperkalemia and hypocalcemia, which suppress the entire cardiovascular tree.