Rhabdomyolysis: Admit to the ICU!!!
- Tx: ***IV fluid rehydration!!! (give a significant amount of fluid) – start immediately, high volume!
- After hydration is achieved, then start alkalization of urine (want pH +6): IV Bicarbonate.
- CPK level: Very elevated! Measurement of myositis (muscle break down) (Ex: +10,000)
- UA: “very bloody” but NO RBCs (not blood but myoglobin causes dark urine: “tea colored”)
- Sx: Muscle tenderness and decreased muscle strength (muscle breakdown: high potassium, high phosphate, low calcium)
- Renal failure (high Cr and BUN): Secondary to myoglobin clogging filtration – IV fluid helps clear this
- Causes: Alcohol, cocaine, severe trauma, extreme exertion
- Look for the following medications and STOP them: Metformin, statins, NSAIDs