Table 2

Rhabdomyolysis consensus summary

Populations at risk
  • Large burden of injury involving muscle.

  • Vascular injury or muscle ischemia.

  • Extreme exertional demands/toxins.

Clinical findings
  • May be asymptomatic.

  • Acute muscle weakness.

  • Pain/tender/swelling involved extremity.

Laboratory findings
  • CK >5× upper limit of normal or >1000 IU/L.

  • Elevated myoglobin, LDH, K+, Cr, and AST.

Fluid management
  • LR or NaCl (0.9 or 0.45%) initiated at 400 cc/hour.

Urine output goals
  • 1–3 cc/kg/hour.

  • Up to 300 cc/hour.

Diuretic/bicarbonate therapy
  • Diuretics not recommended.

  • Bicarbonate not recommended.

Electrolyte abnormalities
  • Elevated K+ and phosphate.

  • Decreased calcium.

Renal replacement therapy
  • No role for RRT in AKI prevention.

  • Rhabdo with AKI: CRRT or intermittent RRT.

  • No recommendation on RRT modalities.

Complications of rhabdomyolysis
  • AKI.

  • DIC.

  • Compartment syndrome.

Predictors of AKI development
  • Based on demographic and clinical laboratory variables.

  • McMahon Score for RRT need.

  • AKI, acute kidney injury; AST, aspartate aminotransferase; CK, creatine kinase; Cr, creatinine; CRRT, continuous renal replacement therapy; DIC, disseminated intravascular coagulation; K+, potassium; LDH, lactate dehydrogenase; LR, lactated Ringer’s solution; RRT, renal replacement therapy.