Rhabdomyolysis: Admit to the ICU!!!

  • Tx: ***IV fluid rehydration!!! (give a significant amount of fluid) – start immediately, high volume!
    1. 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

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