Rhabdomyolysis involves damage to the skeletal muscle fibers and the release of toxic intracellular contents into the circulation. The clinical spectrum of Rhabdomyolysis is rather wide and variable. It can range from asymptomatic elevation in serum creatine kinase levels to organ damage including renal failure, hepatic dysfunction, disseminated intravascular coagulation, arrhythmias and cardiac arrest. The common cause of Rhabdomyolysis is direct trauma to the muscle but can also be caused by any abnormality that affects the energy metabolism. Diagnosis is made using clinical findings and laboratory data. An elevated serum creatine kinase level is the most sensitive indicator for myocyte injury. The mainstay of treatment is aggressive intravenous fluid (IVF) resuscitation, correction of electrolyte abnormalities and treating the underlying cause of muscle damage. There are no large randomized control trials to study the use of adjunctive therapies such as alkalinization of urine with sodium bicarbonate or diuretic use. The available retrospective data fails to establish clinical benefit to support the use of the above mentioned adjunctive therapies compared to treatment with IVF alone.
KeywordsRhabdomyolysis Trauma Muscle injury Renal failure Creatine kinase Intravenous fluids Alkalinization of urine Diuretics
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