Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- recent crush injury
- prolonged immobilization
- presence of other risk factors
- muscular pain or weakness
Outros fatores diagnósticos
- general malaise
- dark urine
- muscular swelling
- muscular tenderness
- diminished peripheral pulse
- prolonged capillary refill
Fatores de risco
- trauma
- alcohol
- cocaine
- amphetamine
- phencyclidine
- narcotics
- diuretics
- statins
- salicylate toxicity
- toxins
- envenomation
- inflammatory disorders
- muscle hypoxia
- genetic disorders
- metabolic disorders
- infection
- increased body temperature
- antipsychotics
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- serum creatine kinase (CK) level
- serum electrolytes
- renal function
- liver function
- CBC
- coagulation studies
- urine dipstick
- urine microscopy
- myoglobin levels
Investigações a serem consideradas
- muscle biopsy
- thyroid-stimulating hormone
- erythrocyte sedimentation rate
- antinuclear antibodies
- toxicology screen
Algoritmo de tratamento
crush injury and/or creatine kinase >5 times normal or >1000 IU/L
acute kidney injury refractory to initial therapy
Colaboradores
Autores
Chinmay Patel, MD, FASN
Nephrology Specialist
East Texas Kidney Specialists
Longview
TX
Declarações
CP is an author of one reference cited in this topic.
Aditya Kadiyala, MD, MPH
Vice Chair
Department of Medicine
Division of Nephrology
University of Maryland
Charles Regional Medical Center
La Plata
MD
Declarações
AK declares that he has no competing interests.
Agradecimentos
Dr Chinmay Patel and Dr Aditya Kadiyala would like to gratefully acknowledge Dr Mark Shapiro, Dr Courtney Sommer, and Dr Robert D. Mathis, previous contributors to this topic.
Declarações
MS is an author of references cited in this topic. CS and RDM declare that they have no competing interests.
Revisores
Timothy Albertson, MD, PhD, MPH
Chief
Division of Pulmonary and Critical Care Medicine
University of California, Davis
Sacramento
CA
Declarações
TA declares that he has no competing interests.
Referências
Principais artigos
Kodadek L, Carmichael Ii SP, Seshadri A, et al. Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document. Trauma Surg Acute Care Open. 2022;7(1):e000836.Texto completo Resumo
The Renal Association (UK). Clinical practice guideline: acute kidney injury (AKI). Aug 2019 [internet publication].Texto completo
Sawhney JS, Kasotakis G, Goldenberg A, et al. Management of rhabdomyolysis: a practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg. 2022 Jul;224(1 pt a):196-204.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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