Rhabdomyolysis in a Tertiary PICU: A 10-Year Study

Objectives: Rhabdomyolysis is a disorder of muscle breakdown. The aim of this study was to describe the epidemiology of rhabdomyolysis in children admitted to a PICU and to assess the relationship between peak creatinine kinase and mortality. Design: Retrospective cohort study in children admitted to the PICU with rhabdomyolysis between January 1, 2005, and December 31, 2014. Demographic, clinical, and outcome data were recorded. Outcomes were analyzed by level of peak creatinine kinase value (0–10,000, 10,001–50,000,> 50,000IU/L). Long-term renal outcomes were reported for PICU survivors. Setting: A single-centre academic tertiary PICU. Patients: Children admitted to the PICU with serum creatinine kinase level greater than 1,000 IU/L. Interventions: None. Measurements and Main Results: There were 182 children with rhabdomyolysis. The median peak creatinine kinase value was 3,583 IU/L (1,554–9,608). The primary diagnostic categories included sepsis, trauma, and cardiac arrest. Mortality for peak creatinine kinase values 0–10,000, 10,001–50,000, and> 50,000 IU/L were 24/138 (17%), 6/28 (21%), and 3/16 (19%), respectively (p = 0.87). Children with a peak creatinine kinase greater than 10,000 IU/L had a longer duration of mechanical ventilation and ICU length of stay than children with peak creatinine kinase less than 10,000. Renal replacement therapy was administered in 29/182 (16%). There was longer duration of mechanical ve...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

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We report on a 39-year-old nulligravida who developed rhabdomyolysis after prolonged laparoscopic surgery for cervical cancer and adhesions due to deep infiltrating endometriosis. Minimally invasive surgical procedures offer major advantages in gynecologic cancer surgery, and preventive methods provide effective pressure reduction and play a crucial role in avoiding physical harm after surgical positioning. Nevertheless, a combination of surgical and patient-related risk factors may increase the risk of postsurgical onset of rhabdomyolysis. Immediate referral to a specialist center is necessary to ensure prevention of serious complications.
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Publication date: Available online 23 June 2018 Source:Molecular Genetics and Metabolism Author(s): Tatiana N. Tarasenko, Kristina Cusmano-Ozog, Peter J. McGuire Despite judicious monitoring and care, patients with fatty acid oxidation disorders may experience metabolic decompensation due to infection which may result in rhabdomyolysis, cardiomyopathy, hypoglycemia and liver dysfunction and failure. Since clinical studies on metabolic decompensation are dangerous, we employed a preclinical model of metabolic decompensation due to infection. By infecting mice with mouse adapted influenza and using a pair-feeding strategy i...
Source: Molecular Genetics and Metabolism - Category: Genetics & Stem Cells Source Type: research
AbstractMitochondrial fatty acid oxidation is an essential pathway for energy production, especially during prolonged fasting and sub-maximal exercise. Long-chain fatty acids are the most abundant fatty acids in the human diet and in body stores, and more than 15 enzymes are involved in long-chain fatty acid oxidation. Pathogenic mutations in genes encoding these enzymes result in a long-chain fatty acid oxidation disorder in which the energy homeostasis is compromised and long-chain acylcarnitines accumulate. Symptoms arise or exacerbate during catabolic situations, such as fasting, illness and (endurance) exercise. The c...
Source: Reviews in Endocrine and Metabolic Disorders - Category: Endocrinology Source Type: research
ConclusionFurther studies into the biology of sequential immunotherapy in the treatment of cancer are warranted.
Source: Journal for Immunotherapy of Cancer - Category: Cancer & Oncology Source Type: research
Journal of Veterinary Emergency and Critical Care, EarlyView.
Source: Journal of Veterinary Emergency and Critical Care - Category: Veterinary Research Authors: Source Type: research
We present a case of exertional rhabdomyolysis in a mixed martial artist with sickle cell trait in order to illustrate the hazards of weight cutting and ensuing critical illness. Sickle cell trait is known to predispose patients to exertional rhabdomyolysis and multiple fatal cases have been reported in the setting of strenuous exercise. Dehydration and consequent electrolyte abnormalities make combat sport athletes with sickle cell trait particularly vulnerable to this entity. This case suggests a potential role for sickle cell trait screening in this population and underscores the need for safer weight-control practices ...
Source: International Journal of Sport Nutrition and Exercise Metabolism - Category: Sports Medicine Authors: Tags: Int J Sport Nutr Exerc Metab Source Type: research
Abstract Drug-induced rhabdomyolysis (DIR) is an idiosyncratic and fatal adverse drug reaction (ADR) characterized in severe muscle injuries accompanied by multiple-organ failure. Limited knowledge regarding the pathophysiology of rhabdomyolysis is the main obstacle to developing early biomarkers and prevention strategies. Given the lack of a centralized data resource to curate, organize, and standardize widespread DIR information, here we present a Drug-Induced Rhabdomyolysis Atlas (DIRA) that provides DIR-related information, including: a classification scheme for DIR based on drug labeling information; postmark...
Source: Drug Discovery Today - Category: Drugs & Pharmacology Authors: Tags: Drug Discov Today Source Type: research
Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with hypopituitarism, adrenal insufficiency and hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
CONCLUSIONS: ER is a serious complication of strenuous physical activity that can threaten renal function. ER tends to occur in August, which coincides with the start of football practice when athletes are more likely to be detrained. The condition can occur in Black athletes in the absence of sickle cell trait. ER carries a good prognosis when recognized early and treated adequately. PMID: 29855209 [PubMed - as supplied by publisher]
Source: The Physician and Sportsmedicine Online - Category: Sports Medicine Tags: Phys Sportsmed Source Type: research
Recently, a 17 year old boy from Texas began feeling " super duper sore " after intensely lifting weights and developed this potentially life-threatening condition.
Source: Forbes.com Healthcare News - Category: Pharmaceuticals Authors: Source Type: news
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