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Lab Increased K+, purines, phosphates, lactic acid, thromboplastin, creatine kinase, creatine, BUN, hemoglobinuria, myoglobinuria
rhabdomyolysis(rab?do-mi-ol'i-sis) (ol'i-sez?) plural.rhabdomyolyses [ rhabdo- + myo- + -lysis]
The goals of treatment are to prevent and treat renal dysfunction, reverse electrolyte abnormalities, and correct the underlying cause. Patients are hydrated aggressively with a goal of achieving urine output between 200 and 300 ml/hr. If urine output does not increase with hydration, loop and osmotic diuretics are prescribed to promote diuresis. Dialysis may be needed for the 10% to 20% of patients with rhabdomyolysis who develop renal failure. Urinary alkalinization (as with sodium bicarbonate) increases myoglobin solubility in the urine and thus its elimination from the body. The patient with rhabdomyolysis should also be monitored closely for electrolyte disturbances (hypocalcemia, hyperkalemia) and dysrhythmias and corrections made as quickly as possible. When localized muscle injuries are present (as after trauma) and compartment syndrome is suspected, direct measurement of compartment pressures is used to diagnose the need for fasciotomy. Bedrest is maintained throughout the acute illness phase. As the patient recovers, physical therapy will help maintain range of motion and prevent other complications of immobilization in hospital.