The Internet Book of Critical Care Podcast IBCC Episode 37 - Rhabdomyolysis
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May 16, 2019 This podcast discusses the causes, diagnosis, and management of rhabdomyolysis, including the correlation between CK levels and renal failure risk. It explores the challenges in diagnosing the condition and emphasizes the need for evidence-based treatments. The importance of fluid management, including fluid resuscitation and indications for dialysis, is also highlighted.
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Complex ICU Rhabdomyolysis
- Rhabdomyolysis in ICU patients is often multifactorial, involving trauma, dehydration, and hyperthermia together.
- It's rarely isolated, which complicates understanding the contribution to acute kidney injury.
Lab Patterns in Rhabdomyolysis
- Electrolyte patterns in rhabdomyolysis mimic tumor lysis syndrome: elevated phosphate and potassium, low calcium.
- AST elevation disproportionate to ALT can hint at muscle injury rather than liver injury.
When to Check and Interpret CK
- Check creatinine kinase (CK) for patients with muscle symptoms, high-risk factors, or suspicious labs.
- Use CK over 1000 U/L as the threshold to diagnose rhabdomyolysis, but correlate clinically for treatment decisions.