Rhabdomyolysis: Complications

Rhabdomyolysis is a syndrome involving widespread muscle breakdown and necrosis following muscle injury with subsequent release of K+, CPK, myoglobin and other intramuscular components resulting in several complications including:

• Electrolyte abnormalities
  • Hyperkalemia àrisk of cardiac arrhythmia and arrest
  • Hyperphosphatemia
  • Hypocalcemia à risk of conduction abnormalities and neurological complications (i.e. Seizures)
  • Hyperuricemiaàanion gap metabolic acidosis, gout and renal caculi
• DIC à secondary to release of thromboplastin and other prothrombotic components from damaged muscle
• Compartment Syndromeà especially after aggressive fluid resuscitation resulting in a fluid shift to the closed compartment of the initial muscle insult.
• AKIà especially in the setting of hypovolemia, sepsis, acidosis, renal ischemia and myoglobin accumulation in renal tubules.
• Hypovolemiaà secondary to third spacing following extracellular fluid influx into compartments containing damaged muscle