Understanding
Rhabdomyolysis
Nurse Bob.
Rhabdomyolysis is a condition where there is a massive distruction of
muscle tissue. The large amount of muscle distruction may result in
multiple organ system failure.
Massive muscle damage may result in multople organ system failure.
Myocytes.
Within muscles are some specialized cells called myocytes. These
contain magnesium, potassium, phosphates, acids, creatnine kinase (CK)
and lactic dehydrogenase (LDH), along with myoglobin. These substances
are essential to cell function. They are toxic when excess is released
into the bloodstream.
Elevation of creatnine kinase is the gold standard for rhabdomyolysis.
Normally the CK is about 40-250. However, in rhabdomyolysis this may be
as high as 250,000 units per liter.
Myoglobin.
Myoglobin normally passes through the nephron in the renal
tubles. However, in the acedic condition associated with
rhabdomyolysis the myoglobin may precipate out and cause a
decrease in urine output. This acid may cause damage to the renal
tubles resulting in acute renal failure. This is the most common result
of rhabdomyolysis. One of the earliest symptoms of rhabdomyolysis is
very dark brown urine. Brown cast will be present in the urinalysis
with few red blood cells.
Causes:
Anything that causes large amount of muscle tissue
breakdown.
Exercise to excess.
Toxic substances.
Most common causes are ingestion
of ethylene glycol or methanol.
Illegal drugs such as cocaine,
methamphatamine. These drugs over stimulate the nervous system causing
massive
muscle distruction.
Traumatic injury involving large amounts of muscle
tissue.
Can be caused by muscle hypoxia as in shock.
Hypothermia can cause hypoxia which may resule in
rhabdomyolysis.
Alchol posioning. This usually occurs in binge
drinking.
Massive muscle damage may result in multople organ system failure.