Understanding Rhabdomyolysis
Nurse Bob.


Rhabdomyolysis is a condition where there is a massive distruction of muscle tissue. The large amount of muscle distruction may result in multiple organ system failure.
Massive muscle damage may result in multople organ system failure.

Myocytes.
Within muscles are some specialized cells called myocytes.  These contain magnesium, potassium, phosphates, acids, creatnine kinase (CK) and lactic dehydrogenase (LDH), along with myoglobin. These substances are essential to cell function. They are toxic when excess is released into the bloodstream.

Elevation of creatnine kinase is the gold standard for rhabdomyolysis. Normally the CK is about 40-250. However, in rhabdomyolysis this may be as high as 250,000 units per liter.

Myoglobin.
Myoglobin normally passes through the nephron in the renal tubles.  However, in the acedic condition associated with rhabdomyolysis the myoglobin  may precipate out and cause a decrease in urine output.  This acid may cause damage to the renal tubles resulting in acute renal failure. This is the most common result of rhabdomyolysis. One of the earliest symptoms of rhabdomyolysis is very dark brown urine. Brown cast will be present in the urinalysis with few red blood cells.

Causes:
    Anything that causes large amount of muscle tissue breakdown.
    Exercise to excess.
    Toxic substances.
        Most common causes are ingestion of ethylene glycol or methanol.
        Illegal drugs such as cocaine, methamphatamine. These drugs over stimulate the nervous system causing massive
        muscle distruction.
    Traumatic injury involving large amounts of muscle tissue.
    Can be caused by muscle hypoxia as in shock.
    Hypothermia can cause hypoxia which may resule in rhabdomyolysis.
    Alchol posioning. This usually occurs in binge drinking.
Massive muscle damage may result in multople organ system failure.