Rhabdomyolysis.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search methods or primary human data.
PubMed 32532456 · doi:10.1016/j.disamonth.2020.101015
What was done
This paper is a narrative clinical review summarizing the pathophysiology, clinical presentation, diagnostic criteria, prognostic risk stratification, and management strategies for rhabdomyolysis.
What was found
The diagnosis is confirmed when serum creatine kinase (CK) exceeds 1000 U/L or at least 5 times the upper limit of normal. A McMahon score of 6 or greater calculated on admission is predictive of acute kidney injury (AKI) requiring renal replacement therapy. Management centers on treating the underlying cause, correcting electrolyte abnormalities, and early, aggressive fluid resuscitation using crystalloid solutions. The review notes there is no established clinical benefit for administering bicarbonate infusions or mannitol.
Why it matters
It outlines standard diagnostic thresholds and risk prediction tools (the McMahon score) to identify patients at risk of severe AKI, while reinforcing that aggressive crystalloid hydration remains the primary treatment and discouraging routine use of unproven adjuncts like bicarbonate or mannitol.
Limits
The abstract describes a narrative review rather than a systematic review or primary clinical study, providing no methodology, search criteria, sample sizes, or quantitative effect sizes for the discussed interventions.
Cited by
- supports Electrocution causes rhabdomyolysis, where muscle tissue breaks down and releases toxic enzymes, which can lead to sepsis and death.