Sunday, June 26, 2016
Rhabdomyolysis Part 2
The signs and symptoms of rhabdomyolysis can be subtle and hard to pinpoint. There are many similarities between it and other conditions which means nothing is specific to only it. Rhabdomyolysis may cause the darkening of urine color, either dark red or brown.1 There can also be a reduction or no urine output sometimes. The patient can have abdominal pain and nausea or vomiting as well. They may have a fever and rapid heart rate and have a hard time moving their arms or legs because of muscle weakness.2 Some may have confusion, dehydration, lack of consciousness, or even compartment syndrome as signs and symptoms of rhabdomyolysis. Patients can have muscle aches and pain and stiffness which are very common when you have severe muscle damage.1
There are many physical exams that will show tender or damaged skeletal muscles. These tests help figure out if someone is suffering from rhabdomyolysis. One of the tests is called creatine kinase (CK).1 If there is an increase in CK that indicates that there is indeed muscle damage. They also check how the myoglobin levels are in the patient’s blood, which is called serum myoglobin, while also checking the potassium levels using the serum potassium exam. If there are high levels of potassium in the blood it can cause irregular heartbeats or cardiac arrest and kidney damage.2 This happens with as many as half of the patients. The patient has a urine myoglobin test done to also check the myoglobin levels in the urine.
The best way to treat rhabdomyolysis is to get fluids that contain bicarbonate to help prevent kidney damage.2 While some patients will only need fluid through a vein, others may need a kidney dialysis. Once the patient is well hydrated, ones with normal renal function, normal electrolyte levels, alkaline urine, and an isolated cause of muscle injury may be discharged and monitored as an outpatient.2 If they developed compartment syndrome that they do not get treated fast or early enough, they may have long lasting damage. Medications can also help patients suffering from rhabdomyolysis.1 Bicarbonate and certain kinds of diuretics may be prescribed to help the kidneys keep their function. IV fluids may also help to treat high potassium levels (hyperkalemia) and low blood calcium levels (hypocalcemia).1 There may be a need for dialysis because of kidney damage and acute renal failure that already started to develop. This means that blood is taken out of the body and cleaned in a certain machine to remove sodium, potassium, phosphates, and other waste products and then put back in the body.2
1Rhabdomyolysis: Causes, Symptoms and Treatment. (n.d.). Retrieved April 10, 2016, from http://www.medicinenet.com/rhabdomyolysis/article.htm
2Rhabdomyolysis: Symptoms, Causes, and Treatments. (n.d.). Retrieved April 15, 2016, from http://www.webmd.com/a-to-z-guides/rhabdomyolysis-symptoms-causes-treatments