Rhabdomyolysis and spine surgery: A systematic review of the literature

Portella, Stella Taylor; Acioly, Marcus André

doi:10.1016/j.jocn.2019.08.034

Cited by 8 publications

(8 citation statements)

References 25 publications

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“…Severe trauma patients are particularly susceptible to rhabdomyolysis, owing to a variety of muscle insults, such as blunt trauma, poor muscle perfusion, occasional limb ischemia or muscle compartment syndrome. Moreover, prolonged repair surgeries are commonly required after severe trauma and further worsen rhabdomyolysis by causing a "second traumatic hit" to muscles [1]. Of note, several studies have reported rhabdomyolysis to be a risk factor for post-traumatic acute kidney injury (AKI) [2][3][4] that is independently associated with increased mortality [4].…”

Section: Introductionmentioning

confidence: 99%

Admission serum myoglobin and the development of acute kidney injury after major trauma

Tarazona

Figueiredo

Hamada

et al. 2021

Ann. Intensive Care

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Background Myoglobin and creatine kinase (CK) are both established markers of muscle injury but their hospital admission values have never been compared to predict post-traumatic acute kidney injury (AKI). Methods An observational registry study of consecutive trauma patients admitted to a major regional trauma centre. The primary outcome was stage 1 or more AKI in the first 7 days after trauma. We assessed the association of hospital admission myoglobin or CK with development of AKI both alone and when added to two existing risk prediction models for post traumatic AKI. Results Of the 857 trauma patients (median age 36 [25–52], 96% blunt trauma, median ISS of 20 [12–47]) included, 102 (12%) developed AKI. Admission myoglobin performed better than CK to predict AKI any stage with an AUC–ROC of 0.74 (95% CI 0.68–0.79) and 0.63 (95% CI 0.57–0.69), respectively (p < 0.001). Admission myoglobin also performed better than CK to predict AKI stage 2 or 3 [AUC–ROC of 0.79 (95% CI 0.74–0.84) and 0.74 (95% CI 0.69–0.79), respectively (p < 0.001)] with a best cutoff value of 1217 µg/L (sensitivity 74%, specificity 77%). Admission myoglobin added predictive value to two established models of AKI prediction and showed significant ability to reclassify subjects regarding AKI status, while admission CK did not. Decision curve analysis also revealed that myoglobin added net benefit to established predictive models. Admission myoglobin was better than CK at predicting development of significant rhabdomyolysis. Conclusions Admission myoglobin better predicts the development of AKI and severe rhabdomyolysis after major trauma. Admission myoglobin should be added in established predictive models of post-traumatic AKI to early identify high-risk patients.

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Section: Introductionmentioning

confidence: 99%

Admission serum myoglobin and the development of acute kidney injury after major trauma

Tarazona

Figueiredo

Hamada

et al. 2021

Ann. Intensive Care

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“…The best available evidence indicates that the prognosis depends on the extension and clinical severity of rhabdomyolysis as well as on early and prompt medical intervention. 13 We have reported this case to aid physicians in the diagnosis of rhabdomyolysis caused by chronic pressure ulcers.…”

Section: Discussionmentioning

confidence: 94%

Successful management of rhabdomyolysis with acute infection resulting from chronic sacrococcygeal pressure ulcers in a paraplegic patient: a case report

Huang

Zhu

2021

J Int Med Res

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Rhabdomyolysis, a potentially life-threatening syndrome, is caused by the breakdown of skeletal muscle cells and leakage of intramyocellular contents into the bloodstream. The treatment of rhabdomyolysis resulting from chronic sacrococcygeal pressure ulcers has been rarely reported. A 62-year-old man developed a high fever and dark-colored urine. For the past 30 years, he had lived with paraplegia, which led to his immobility. Physical examination showed evidence of repeated dehiscence and exudation of the wound on his sacrococcygeal region with loss of skin sensation. Upon corroboration of the physical examination findings and laboratory test results, the patient was diagnosed with rhabdomyolysis with an acute infection resulting from sacrococcygeal pressure ulcers. We first debrided the necrotic tissue and then repaired the chronic ulcer. The wound dressing was changed frequently, and antimicrobial therapy and nutritional support were included in the treatment. The fever and dark-colored urine gradually resolved postoperatively. The patient’s renal function also improved according to the typical laboratory indicators, and the size of the pressure ulcers decreased to some extent. The patient was discharged after 1 month of hospitalization. This case highlights that accurate diagnosis is critical for administration of precise treatment to paraplegic patients with progressive rhabdomyolysis.

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“…RM following surgery is a quite uncommon event, but nonetheless increased intracompartmental pressure and muscular ischemia can lead to RM. 10,11 Prolonged duration of surgery and intraoperative unusual positions are described as risk factors. 12 Both surgeon and anesthesiologist should be aware of the risk, monitor the patient carefully, and initiate aggressive therapy if the diagnose is confirmed.…”

Section: Discussionmentioning

confidence: 99%

Rapid reduction of substantially increased myoglobin and creatine kinase levels using a hemoadsorption device (CytoSorb^®)—A case report

Moresco

Rugg

Ströhle

et al. 2022

Clinical Case Reports

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Rhabdomyolysis and spine surgery: A systematic review of the literature

Cited by 8 publications

References 25 publications

Admission serum myoglobin and the development of acute kidney injury after major trauma

Admission serum myoglobin and the development of acute kidney injury after major trauma

Successful management of rhabdomyolysis with acute infection resulting from chronic sacrococcygeal pressure ulcers in a paraplegic patient: a case report

Rapid reduction of substantially increased myoglobin and creatine kinase levels using a hemoadsorption device (CytoSorb^®)—A case report

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Rhabdomyolysis and spine surgery: A systematic review of the literature

Cited by 8 publications

References 25 publications

Admission serum myoglobin and the development of acute kidney injury after major trauma

Admission serum myoglobin and the development of acute kidney injury after major trauma

Successful management of rhabdomyolysis with acute infection resulting from chronic sacrococcygeal pressure ulcers in a paraplegic patient: a case report

Rapid reduction of substantially increased myoglobin and creatine kinase levels using a hemoadsorption device (CytoSorb®)—A case report

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Rapid reduction of substantially increased myoglobin and creatine kinase levels using a hemoadsorption device (CytoSorb^®)—A case report