Podcast 660: Rhabdomyolysis

<p><strong>Contributor:  Ricky Dhaliwal, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Rhabdomyolysis occurs when high levels of myoglobin are released from dying muscle tissue into the blood</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Severe levels of myoglobin cause renal injury</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Causes include elevated temperature, excessive exercise, toxins, infection, muscle ischemia, crush injury, and prolonged immobilization</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Can also be caused by medications, like antipsychotics, statins, SSRIs, colchicine, lithium</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Workup typically includes  creatinine kinase, potassium, creatinine levels and serial EKGs</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Firstline treatment is with  IV fluids with a goal urine output of 300 ml/hr</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Sodium bicarbonate and mannitol have had some use in treatment but weak evidence</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Long B, Koyfman A, Gottlieb M. An evidence-based narrative review of the emergency department evaluation and management of rhabdomyolysis. Am J Emerg Med. 2019 Mar;37(3):518-523. doi: 10.1016/j.ajem.2018.12.061. Epub 2019 Jan 2. PMID: 30630682.</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD</span></em></p> <p> </p> <p><span style="font-weight: 400;">The Emergency Medical Minute is excited to announce that we are now offering</span> <em><span style="font-weight: 400;">AMA PRA Category 1 credits™</span></em> <span style="font-weight: 400