Rhabdomyolysis

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.

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Definition/Description

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Prevalence

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Characteristics/Clinical Presentation

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Associated Co-morbidities

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Medications

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Causes

Causes for rhabdomyolysis can be broken down into 2 categories, hereditary causes and acquired causes.

Hereditary Causes

Those that are at risk for rhabdomyolysis have a family history of disorders dealing with carbohydrate metabolism as well as disorders of lipid metabolism.  Disorders of lipid metabolism include malignant hyperthermia, mitochondrial disorders, as well as other genetic disorders.

Acquired Causes

Some of the most common acquired causes include trauma or crush injury, toxic, sever muscle exertion, seizures, shaking chills, delerium tremors, ischemia or muscle necrosis, metabolic disorders, bacterial and viral infections, heat-induced (malignant hyperthermia, heat intolerance, heat stroke), inflammatory, certain drugs (overuse or overdose) such as cocaine, amphetamines, statins, heroin, PCP, as well as low phosphate levels.

Below is a chart that describes the risk factors for rhabdomyolysis as well as examples of the risk factors and associated signs and symptoms.   

Risk Factors For Postoperative Rhabdomyolysis

Preoperative

•Male

•Age > 10 years

•BMI > 55 kg/m2

•History of hypertension, diabetes mellitus, or peripheral vascular disease

•History of statin use

•elevated preoperative serum CPK level

Intraoperative

•Operation duration > 5hours

•Anesthesia time > 6 hours

•Inadequate hydration

•Urine output < 1.5ml/kg/h

•Bleeding and/or hypotension

•Use of propofol and/or succinylcholine

Postoperative

•Complaints of muscle pain and weakness

•Delayed ambulation

•Urine otuput <1.5mL/kg/h

•Serum CPK > 1,000IU/L

•Urine myoglobin > 250m g/L

Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports

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Resources

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Recent Related Research (from Pubmed)

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References

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