Management and conduct of rhabdomyolysis: a review of the literature

Abstract

Objective: To review and present basic concepts of rhabdomyolysis, delving into the management and conduct in the emergency department. Literature review: Rhabdomyolysis is defined by the breakdown of muscle tissue with release of intracellular enzymes into the bloodstream. Drugs that affect muscles such as statins, infections, traumas, and electrolyte imbalances can lead to rhabdomyolysis. The clinical picture varies according to the severity of the case, and the degree and extension of the muscle damage. The main symptoms of the disease are myalgia, myasthenia, choluria, and elevated creatine kinase (CK). As initial management, it is necessary to perform an aggressive volume replacement. Hyperkalemia is the most life-threatening electrolyte abnormality in this pathology, and its correction can be accomplished by the use of insulin and intravenous glucose. If the patient develops acute renal failure, measures should be taken to control the overload. Therefore, renal replacement therapy should be considered. Final considerations: Rhabdomyolysis is characterized by muscle destruction with release of its components into the bloodstream. In this sense, it becomes necessary to perform the appropriate and early management during the management of this disease in the emergency department, in order to decrease the chances of severe complications and death of the patient.