Risk factors and outcome of rhabdomyolysis after cardiac surgery

Hajjar, L; Grande, Solimar Miranda; Galas, F; Roquim, A; Sampaio, Leticia P. B; Auler, José Otávio Costa

doi:10.1186/cc6691

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…A correlation of RML and direct femoral artery cannulation, arteriopathy, prolonged extracorporal circulation, low cardiac output syndrome, and continuous intravenous infusion of epinephrine could be shown. There have not been many published studies of RML in adult patients undergoing CPB [ 13 ]. We report a case of a patient who developed RML with acute renal injury following CABG.…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures

et al. 2014

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BackgroundPost-operative rhabdomyolysis is a well-known complication, especially after bariatric and orthopaedic surgeries. There are few published reports of rhabdomyolysis following cardiac surgery. Acute kidney injury had been distinguished as a serious complication of cardiac surgery. We report a case of 55-years-old male patient who developed rhabdomyolysis precipitated acute kidney injury after coronary artery bypass graft.Case presentationThe patient underwent urgent coronary artery bypass graft surgery, with a long duration of surgery due to technical difficulty during grafting. He developed rhabdomyolysis induced acute kidney injury necessitating hemodialysis. The patient in turn developed heart failure, which along with acute kidney injury lead to prolonged ventilation. There was supervening sepsis with prolonged intensive care unity stay and eventually prolonged hospitalization. The peak creatine kinase level was 39000 IU/mL and peak myoglobin was 40000 ng/ml. Reviewing the patient, surgery was prolonged due to technical difficulties encountered during grafting, leading to rhabdomyolysis induced acute kidney injury. The pre-operative use of statins by the patient could also have contributed to the development of rhabdomyolysis. He developed post-operative right heart failure and sepsis. The patient’s renal function gradually improved over 4 week’s duration. Favorable outcome could be achieved but after prolonged course of renal replacement therapy in the form of hemodialysis.ConclusionProlonged duration of surgery is a well-recognized risk factor in the development of rhabdomyolysis. Early recognition of rhabdomyolysis induced acute kidney injury is important in reducing the post-operative morbidity and mortality in patients. A protocol based approach could be applied for early recognition and management.

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Section: Introductionmentioning

confidence: 99%

Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures

et al. 2014

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“…We recruited 202 patients in our study, 185 males and 17 females with mean age 52 ± 12.4 years. According to the existence of RML (CK 2,500 U/ml or more) [ 1 ], patients were divided into group 1 where RML was identified in 17 patients (8.4%), which was associated with AKI in seven patients (41%), and group 2 without RML (185 patients), where AKI occurred in 34 patients (18.4%) ( P = 0.025). We observed a significantly longer duration of ventilation and lengths of stay in the ICU and in hospital in the RML group ( P < 0.01 for all observations).…”

Section: Resultsmentioning

confidence: 99%

Rhabdomyolysis following cardiac surgery: from prevalence to prevention

et al. 2014

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“…Postcardiac surgery RML was suspected when serum CK levels were 2500 U/L or higher [ 11 ]. According to the consensus definition proposed by the Acute Kidney Injury Network, AKI was defined as an abrupt (within 48 h) reduction in kidney function, defined as an absolute increase in serum creatinine concentration of 0.3 mg/dL or greater (26.4 μ mol/L) or a percentage increase of 50% or greater (1.5-fold from baseline) [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…A fivefold elevation of serum creatine kinase (CK) levels (1050 U/L) is considered diagnostic for RML (males: CK > 1160 U/L; females: CK > 1075 U/L) [ 3 , 10 ]. In cardiac surgery a higher set value to diagnose RML is described due to release of CK from related myocardial injury (2500 U/L) [ 11 ]. Severe RML is diagnosed when CK levels are higher than 10,000 U/L [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Rhabdomyolysis following Cardiac Surgery: A Prospective, Descriptive, Single-Center Study

Omar

Ewila

Aboulnaga

et al. 2016

BioMed Research International

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Purpose. Rhabdomyolysis (RML) following cardiac surgery and its relationship with acute kidney injury (AKI) require investigation. Patients and Methods. All patients undergoing cardiac surgery in our hospital were enrolled in this prospective study during a 1-year period. To investigate the occurrence of RML and its association with AKI, all patients in the study underwent serial assessment of serum creatine kinase (CK) and myoglobin levels. Serial renal function, prior statin treatment, and outcome variables were recorded. Results. In total, 201 patients were included in the study: 185 men and 16 women with a mean age of 52.0 ± 12.4 years. According to the presence of RML (CK of ≥2,500 U/L), the patients were divided into Group I (RML present in 17 patients) and Group II (RML absent in 184 patients). Seven patients in Group I had AKI (41%) where 34 patients in group II had AKI (18.4%), P = 0.025. We observed a significantly longer duration of ventilation, length of stay in the ICU, and hospitalization in Group I (P < 0.001 for all observations). Conclusions. An early elevation of serum CK above 2500 U/L postoperatively in high-risk cardiac surgery could be used to diagnose RML that may predict the concomitance of early AKI.

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Risk factors and outcome of rhabdomyolysis after cardiac surgery

Cited by 4 publications

References 2 publications

Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures

Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures

Rhabdomyolysis following cardiac surgery: from prevalence to prevention

Rhabdomyolysis following Cardiac Surgery: A Prospective, Descriptive, Single-Center Study

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