Search In this Thesis
   Search In this Thesis  
العنوان
Manifestations Early Detection and Management of Rhabdomyolysis in Critically Ill Patient in ICU /
المؤلف
Al-Gendy, Khaled Mostafa Mohamed.
هيئة الاعداد
باحث / خالد مصطفي محمد الجندي
مشرف / محمد حسام شقير
مشرف / أشرف نبيل صالح
تاريخ النشر
2020.
عدد الصفحات
105 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2020
مكان الإجازة
جامعة عين شمس - كلية الطب - التخدير والرعاية المركزة
الفهرس
Only 14 pages are availabe for public view

from 187

from 187

Abstract

Rhabdomyolysis is the rapid breakdown of striated muscles caused by wide variety of conditions including trauma, drugs, viruses, metabolic disorders; Rhabdomyolysis is a potential fatal condition with mortality of approximately 8%.
• In the ICU setting, the most common causes of rhabdomyolysis are muscular trauma and vascular obstruction. Rhabdomyolysis occurs in up to 85% of patients with traumatic injuries. Alcohol has been implicated in the development of rhabdomyolysis in up to 20% of cases. Patients with severe injuries that develop rhabdomyolysis induced renal failure have a mortality of approximately 20% but are higher if multiple organ dysfunction is present.
• Causes of rhabdomyolysis are divided into hereditary and acquired ones. The hereditary causes are mainly related to a lack or insufficiency of enzymes that participate in the catabolism of different energy macromolecules, the acquired causes are classified as traumatic and non-traumatic. The traumatic ones, such as crush syndrome, accidents, natural disasters, or intense exercise, cause direct muscle injury and rupture of the sarcolemma. The non-traumatic causes are the most common ones during peacetime and include alcohol abuse, medicines e.g., statins.
• Although the causes of rhabdomyolysis are so diverse, the pathogensis appears to follow a final common pathway, ultimately leading to myocyte destruction and release of muscle components into the circulation.
• The clinical presentation is extremely variable; due to the large range of cause of this condition, it may vary from subclinical to severe, depending upon the extent and severity of muscle damage.
• The classic triad of symptoms of rhabdomyolysis includes muscle pain, weakness and dark urine.
• Diagnosis of rhabdomyolysis is based on elevated serum creatine kinase (CK) levels more than 1000u/L.
• Mild rhabdomyolysis can be treated by drinking lots of fluids. Severe cases require hospitalization and aggressive treatment with intravenous fluids to dilute the proteins to minimize their damage to the kidney and monitor the heart for dangerous rhythm changes from the surge of electrolytes. In severe cases, the kidneys may fail and immediate dialysis is needed to mechanically remove proteins and electrolytes from the blood.
• The complications of rhabdomyolysis include: hypovolemia, compartment syndrome, arrhythmia, disseminated intravascular coagulation, hepatic dysfunction and acute renal failure.
• Acute kidney injury associated with myoglobinuria is the most serious compilation of both traumatic and non-traumatic rhabdomyolysis, and it may be life-threatening. The reported incidence ranges from 13% to approximately 50%.