Rabdomiólisis
Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- lesión por aplastamiento reciente
- inmovilización prolongada
- presencia de otros factores de riesgo
- dolor o debilidad muscular
Другие диагностические факторы
- malestar general
- orina oscura
- inflamación muscular
- sensibilidad muscular
- pulso periférico disminuido
- llenado capilar prolongado
Факторы риска
- traumatismo
- alcohol
- cocaína
- anfetaminas
- fenciclidina
- narcóticos
- diuréticos
- estatinas
- toxicidad por salicilatos
- toxinas
- inoculación de veneno
- trastornos inflamatorios
- hipoxia muscular
- trastornos genéticos
- trastornos metabólicos
- infección
- aumento de la temperatura corporal
- antipsicóticos
Диагностические исследования
Исследования, которые показаны в первую очередь
- nivel de creatina-cinasa sérica (CK)
- electrolitos séricos
- función renal
- función hepática
- hemograma completo (HC)
- estudios de coagulación
- tira reactiva de orina
- análisis microscópico de orina
- niveles de mioglobina
Исследования, проведение которых нужно рассмотреть
- biopsia muscular
- hormona estimulante de la tiroides
- velocidad de sedimentación globular
- anticuerpos antinucleares
- cribado toxicológico
Алгоритм лечения
lesión por aplastamiento y/o creatina-cinasa >5 veces lo normal o >1000 UI/L
daño renal agudo refractario al tratamiento inicial
Составители
Авторы
Chinmay Patel, MD, FASN
Nephrology Specialist
East Texas Kidney Specialists
Longview
TX
Раскрытие информации
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
Disclosures
AK declares that he has no competing interests.
Acknowledgements
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.
Disclosures
MS is an author of references cited in this topic. CS and RDM declare that they have no competing interests.
Peer reviewers
Timothy Albertson, MD, PhD, MPH
Chief
Division of Pulmonary and Critical Care Medicine
University of California, Davis
Sacramento
CA
Disclosures
TA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
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.Full text Abstract
The Renal Association (UK). Clinical practice guideline: acute kidney injury (AKI). Aug 2019 [internet publication].Full text
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Infarto de miocardio
- Gripe
- Fibromialgia
More DifferentialsGuidelines
- Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document
- Clinical practice guidelines for exertional rhabdomyolysis: a military medicine perspective
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer