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Rhabdomyolysis Medication

  • Author: Eyal Muscal, MD, MS; Chief Editor: Lawrence K Jung, MD  more...
 
Updated: Jun 22, 2015
 

Medication Summary

Medical therapy for rhabdomyolysis focuses on restoring adequate intravascular volume. Hydration with isotonic sodium chloride solution (0.9% NaCl) is the cornerstone of rhabdomyolysis therapy. Many clinicians recommend the use of sodium bicarbonate. Use furosemide or other diuretics (such as mannitol in adults) with sufficient hydration if urine output is inadequate. Hyperkalemia should also be addressed.

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Volume Expanders

Class Summary

The use of crystalloid solutions is the cornerstone of rhabdomyolysis therapy.

Sodium chloride 0.9%

 

Aggressive and early hydration with isotonic sodium chloride solution is important for the prevention of pigment-associated renal failure.

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Diuretics, Loop

Class Summary

Loop diuretics promote the excretion of water and electrolytes by the kidneys.

Furosemide (Lasix)

 

Furosemide increases water excretion by interfering with the chloride-binding cotransport system; this, in turn, inhibits sodium and chloride reabsorption in the ascending loop of Henle and the distal renal tubule. Dosing must be individualized. Depending on the response, administer at increments of 20-40 mg every 6-8 hours until the desired diuresis occurs. When treating infants, titrate in increments of 1 mg/kg until a satisfactory effect is achieved.

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Diuretics, Osmotic Agents

Class Summary

Osmotic diuretics increase osmolarity of glomerular filtrate and induce diuresis. They hinder tubular reabsorption of water, causing sodium and chloride excretion to increase.

Mannitol (Osmitrol)

 

Mannitol is an alternative diuretic used when urine output is inadequate despite aggressive fluid therapy. Initially, assess for adequate renal function in adults by administering a test dose of 200 mg/kg intravenously (IV) over 3-5 minutes; this should produce a urine flow of at least 30-50 mL/h over 2-3 hours. In children, assess for adequate renal function by administering a test dose of 200 mg/kg IV over 3-5 minutes; this should produce a urine flow of at least 1 mL/h over 1-3 hours.

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Antidotes, Other

Class Summary

Intracellular potassium transporters are used to decrease serum potassium levels. Insulin causes a transcellular shift of potassium into muscle cells, thereby temporarily lowering serum levels of potassium.

Potassium exchange resins decrease serum potassium levels. Sodium polystyrene sulfonate is an exchange resin that can be used to treat mild-to-moderate hyperkalemia. Each 1 mEq of potassium is exchanged for 1 mEq of sodium.

Insulin regular human (Humulin, Novolin)

 

Regular human insulin stimulates cellular potassium uptake within 20-30 minutes. Administer with dextrose to prevent hypoglycemia. Monitor blood sugar levels frequently.

Sodium polystyrene sulfonate (Kayexalate)

 

Sodium polystyrene sulfonate exchanges sodium for potassium and binds it in the gut, primarily the large intestine. It decreases total-body potassium levels. Onset of action after oral administration ranges from 2-12 hours and takes longer after rectal administration.

Sodium polystyrene sulfonate should not be used as first-line therapy for severe life-threatening hyperkalemia. It may be used in the second stage of therapy to reduce total-body potassium levels. The resin is typically mixed in 25% sorbitol before administration.

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Beta2-Agonists

Class Summary

Beta2 -adrenergic agents are used adjunctively to decrease serum potassium levels temporarily. Albuterol and other beta-adrenergic agents induce the intracellular movement of potassium via stimulation of the sodium-potassium adenosine triphosphatase (Na/K-ATPase) pump. Some studies using nebulized albuterol in adults and children indicate that this method of therapy is effective in lowering serum potassium levels, but peak response is unclear. Therefore, nebulized albuterol has not been established as a first-line therapy in severe hyperkalemia.

Albuterol nebulized

 

Nebulized albuterol is an adrenergic agonist that increases plasma insulin concentrations. This increase in insulin may shift potassium into the intracellular space. The onset of the decrease in potassium occurs at about 30 minutes. The duration of action is dose-dependent and is typically between 2 and 5 hours.

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Alkalinizing Agents

Class Summary

Sodium bicarbonate is administered IV to alkalize urine in patients with rhabdomyolysis. This may prevent toxicity caused by the presence of myoglobin in acidic urine and crystallization of uric acid.

Sodium bicarbonate (Neut)

 

Sodium bicarbonate is useful in alkalization of urine to prevent acute myoglobinuric renal failure. Titrate the dose to raise the pH above 6.5-7.0.

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Contributor Information and Disclosures
Author

Eyal Muscal, MD, MS Assistant Professor, Section of Pediatric Immunology, Allergy, and Rheumatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital

Eyal Muscal, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American College of Rheumatology

Disclosure: Nothing to disclose.

Coauthor(s)

Marietta Morales DeGuzman, MD Assistant Professor, Department of Pediatrics, Baylor College of Medicine; Consulting Staff, Section of Pediatric Rheumatology, Department of Pediatrics, Texas Children's Hospital, Ben Taub General Hospital

Marietta Morales DeGuzman, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Rheumatology, Texas Pediatric Society

Disclosure: Nothing to disclose.

Chief Editor

Lawrence K Jung, MD Chief, Division of Pediatric Rheumatology, Children's National Medical Center

Lawrence K Jung, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Rheumatology, Clinical Immunology Society, New York Academy of Sciences

Disclosure: Nothing to disclose.

Acknowledgements

Sandy Craig, MD, Residency Program Director, Carolinas Medical Center; Associate Professor, Department of Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine

Sandy Craig, MD is a member of the following societies; Alpha Omega Alpha and the Society for Academic Emergency Medicine.

Disclosure: Nothing to disclose.

Herbert S Diamond, MD Adjunct Professor of Medicine, Division of Rheumatology, University of Pittsburgh School of Medicine; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, and Phi Beta Kappa

Disclosure: Merck Ownership interest Other; Smith Kline Ownership interest Other; Zimmer Ownership interest Other

Lance W Kreplick, MD, FAAEM, MMM Medical Director of Hyperbaric Medicine, Fawcett Wound Management and Hyperbaric Medicine; Consulting Staff in Occupational Health and Rehabilitation, Company Care Occupational Health Services; President and Chief Executive Officer, QED Medical Solutions, LLC

Lance W Kreplick, MD, FAAEM, MMM, is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physician Executives

Disclosure: Nothing to disclose.

Barry L Myones, MD Associate Professor, Departments of Pediatrics and Immunology, Pediatric Rheumatology Section, Baylor College of Medicine; Director of Research, Pediatric Rheumatology Center, Texas Children's Hospital

Barry L Myones, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American College of Rheumatology, American Heart Association, American Society for Microbiology, Clinical Immunology Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Tom Scaletta, MD Chair, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine

Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Binita R Shah, MD, FAAP, Professor of Clinical Pediatrics and Emergency Medicine, SUNY Health Sciences Center at Brooklyn; Director of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, Kings County Hospital Center

Binita R Shah, MD, FAAPis a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Renee Wilson, MD, Clinical Assistant Instructor, Department of Emergency Medicine, SUNY-Downstate and Kings County Hospital

Renee Wilson, MDis a member of the following medical societies: Society for Academic Emergency Medicine

Disclosure: Nothing to disclose

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
  1. Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol. 2000 Aug. 11(8):1553-61. [Medline]. [Full Text].

  2. Paller MS. Hemoglobin- and myoglobin-induced acute renal failure in rats: role of iron in nephrotoxicity. Am J Physiol. 1988 Sep. 255(3 Pt 2):F539-44. [Medline].

  3. Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med. 2009 Jul 2. 361(1):62-72. [Medline].

  4. Beetham R. Biochemical investigation of suspected rhabdomyolysis. Ann Clin Biochem. 2000 Sep. 37 ( Pt 5):581-7. [Medline].

  5. Better OS. The crush syndrome revisited (1940-1990). Nephron. 1990. 55(2):97-103. [Medline].

  6. Mannix R, Tan ML, Wright R, Baskin M. Acute pediatric rhabdomyolysis: causes and rates of renal failure. Pediatrics. 2006 Nov. 118(5):2119-25. [Medline].

  7. Cervellin G, Comelli I, Lippi G. Rhabdomyolysis: historical background, clinical, diagnostic and therapeutic features. Clin Chem Lab Med. 2010 Jun. 48(6):749-56. [Medline].

  8. Gabow PA, Kaehny WD, Kelleher SP. The spectrum of rhabdomyolysis. Medicine (Baltimore). 1982 May. 61(3):141-52. [Medline].

  9. Watemberg N, Leshner RL, Armstrong BA, Lerman-Sagie T. Acute pediatric rhabdomyolysis. J Child Neurol. 2000 Apr. 15(4):222-7. [Medline].

  10. Elsayed EF, Reilly RF. Rhabdomyolysis: a review, with emphasis on the pediatric population. Pediatr Nephrol. 2010 Jan. 25(1):7-18. [Medline].

  11. Luck RP, Verbin S. Rhabdomyolysis: a review of clinical presentation, etiology, diagnosis, and management. Pediatr Emerg Care. 2008 Apr. 24(4):262-8. [Medline].

  12. Brumback RA, Feeback DL, Leech RW. Rhabdomyolysis in childhood. A primer on normal muscle function and selected metabolic myopathies characterized by disordered energy production. Pediatr Clin North Am. 1992 Aug. 39(4):821-58. [Medline].

  13. Sitprija V. Animal toxins and the kidney. Nat Clin Pract Nephrol. 2008 Nov. 4(11):616-27. [Medline].

  14. Huerta-Alardín AL, Varon J, Marik PE. Bench-to-bedside review: Rhabdomyolysis -- an overview for clinicians. Crit Care. 2005 Apr. 9(2):158-69. [Medline]. [Full Text].

  15. Malinoski DJ, Slater MS, Mullins RJ. Crush injury and rhabdomyolysis. Crit Care Clin. 2004 Jan. 20(1):171-92. [Medline].

  16. Schwengel D, Ludwig S. Rhabdomyolysis and myoglobinuria as manifestations of child abuse. Pediatr Emerg Care. 1985 Dec. 1(4):194-7. [Medline].

  17. Peebles J, Losek JD. Child physical abuse and rhabdomyolysis: case report and literature review. Pediatr Emerg Care. 2007 Jul. 23(7):474-7. [Medline].

  18. Singh U, Scheld WM. Infectious etiologies of rhabdomyolysis: three case reports and review. Clin Infect Dis. 1996 Apr. 22(4):642-9. [Medline].

  19. Nauss MD, Schmidt EL, Pancioli AM. Viral myositis leading to rhabdomyolysis: a case report and literature review. Am J Emerg Med. 2009 Mar. 27(3):372.e5-372.e6. [Medline].

  20. Patel N, Patel N, Espinoza LR. HIV infection and rheumatic diseases: the changing spectrum of clinical enigma. Rheum Dis Clin North Am. 2009 Feb. 35(1):139-61. [Medline].

  21. Wang YM, Zhang Y, Ye ZB. Rhabdomyolysis following recent severe coxsackie virus infection in patient with chronic renal failure: one case report and a review of the literature. Ren Fail. 2006. 28(1):89-93. [Medline].

  22. Pirounaki M, Liatsos G, Elefsiniotis I, Skounakis M, Moulakakis A. Unusual onset of varicella zoster reactivation with meningoencephalitis, followed by rhabdomyolysis and renal failure in a young, immunocompetent patient. Scand J Infect Dis. 2007. 39(1):90-3. [Medline].

  23. Gupta M, Ghaffari M, Freire AX. Rhabdomyolysis in a patient with West Nile encephalitis and flaccid paralysis. Tenn Med. 2008 Apr. 101(4):45-7. [Medline].

  24. Eliasson H, Broman T, Forsman M, Bäck E. Tularemia: current epidemiology and disease management. Infect Dis Clin North Am. 2006 Jun. 20(2):289-311, ix. [Medline].

  25. Antonarakis ES, Wung PK, Durand DJ, Leyngold I, Meyerson DA. An atypical complication of atypical pneumonia. Am J Med. 2006 Oct. 119(10):824-7. [Medline].

  26. Weng WC, Peng SS, Wang SB, Chou YT, Lee WT. Mycoplasma pneumoniae--associated transverse myelitis and rhabdomyolysis. Pediatr Neurol. 2009 Feb. 40(2):128-30. [Medline].

  27. Turhan V, Atasoyu EM, Kucukardali Y, Polat E, Cesur T, Cavuslu S. Leptospirosis presenting as severe rhabdomyolysis and pulmonary haemorrhage. J Infect. 2006 Jan. 52(1):e1-2. [Medline].

  28. Lin AC, Lin CM, Wang TL, Leu JG. Rhabdomyolysis in 119 students after repetitive exercise. Br J Sports Med. 2005 Jan. 39(1):e3. [Medline]. [Full Text].

  29. Scheuerman O, Wanders RJ, Waterham HR, Dubnov-Raz G, Garty BZ. Mitochondrial trifunctional protein deficiency with recurrent rhabdomyolysis. Pediatr Neurol. 2009 Jun. 40(6):465-7. [Medline].

  30. Korematsu S, Kosugi Y, Kumamoto T, Yamaguchi S, Izumi T. Novel mutation of early, perinatal-onset, myopathic-type very-long-chain acyl-CoA dehydrogenase deficiency. Pediatr Neurol. 2009 Aug. 41(2):151-3. [Medline].

  31. Löfberg M, Jänkälä H, Paetau A, Härkönen M, Somer H. Metabolic causes of recurrent rhabdomyolysis. Acta Neurol Scand. 1998 Oct. 98(4):268-75. [Medline].

  32. Agrawal S, Agrawal V, Taneja A. Hypokalemia causing rhabdomyolysis resulting in life-threatening hyperkalemia. Pediatr Nephrol. 2006 Feb. 21(2):289-91. [Medline].

  33. Knochel JP. Hypophosphatemia and rhabdomyolysis. Am J Med. 1992 May. 92(5):455-7. [Medline].

  34. Strachan P, Prisco D, Multz AS. Recurrent rhabdomyolysis associated with polydipsia-induced hyponatremia - a case report and review of the literature. Gen Hosp Psychiatry. 2007 Mar-Apr. 29(2):172-4. [Medline].

  35. Lichtstein DM, Arteaga RB. Rhabdomyolysis associated with hyperthyroidism. Am J Med Sci. 2006 Aug. 332(2):103-5. [Medline].

  36. Pedrozzi NE, Ramelli GP, Tomasetti R, Nobile-Buetti L, Bianchetti MG. Rhabdomyolysis and anesthesia: a report of two cases and review of the literature. Pediatr Neurol. 1996 Oct. 15(3):254-7. [Medline].

  37. Hollander AS, Olney RC, Blackett PR, Marshall BA. Fatal malignant hyperthermia-like syndrome with rhabdomyolysis complicating the presentation of diabetes mellitus in adolescent males. Pediatrics. 2003 Jun. 111(6 Pt 1):1447-52. [Medline]. [Full Text].

  38. Coco TJ, Klasner AE. Drug-induced rhabdomyolysis. Curr Opin Pediatr. 2004 Apr. 16(2):206-10. [Medline].

  39. Hall AP, Henry JA. Acute toxic effects of 'Ecstasy' (MDMA) and related compounds: overview of pathophysiology and clinical management. Br J Anaesth. 2006 Jun. 96(6):678-85. [Medline].

  40. Ahn SC. Neuromuscular complications of statins. Phys Med Rehabil Clin N Am. 2008 Feb. 19(1):47-59, vi. [Medline].

  41. Oshima Y. Characteristics of drug-associated rhabdomyolysis: analysis of 8,610 cases reported to the U.S. Food and Drug Administration. Intern Med. 2011. 50(8):845-53. [Medline].

  42. Wrenn KD, Oschner I. Rhabdomyolysis induced by a caffeine overdose. Ann Emerg Med. 1989 Jan. 18(1):94-7. [Medline].

  43. Holoshitz N, Alsheikh-Ali AA, Karas RH. Relative safety of gemfibrozil and fenofibrate in the absence of concomitant cerivastatin use. Am J Cardiol. 2008 Jan 1. 101(1):95-7. [Medline].

  44. Hung CF, Huang TY, Lin PY. Hypothermia and rhabdomyolysis following olanzapine injection in an adolescent with schizophreniform disorder. Gen Hosp Psychiatry. 2009 Jul-Aug. 31(4):376-8. [Medline].

  45. Wysowski DK, Pollock ML. Reports of death with use of propofol (Diprivan) for nonprocedural (long-term) sedation and literature review. Anesthesiology. 2006 Nov. 105(5):1047-51. [Medline].

  46. Graham DJ, Staffa JA, Shatin D, Andrade SE, Schech SD, La Grenade L, et al. Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs. JAMA. 2004 Dec 1. 292(21):2585-90. [Medline].

  47. Thompson PD, Clarkson P, Karas RH. Statin-associated myopathy. JAMA. 2003 Apr 2. 289(13):1681-90. [Medline].

  48. Urso ML, Clarkson PM, Hittel D, Hoffman EP, Thompson PD. Changes in ubiquitin proteasome pathway gene expression in skeletal muscle with exercise and statins. Arterioscler Thromb Vasc Biol. 2005 Dec. 25(12):2560-6. [Medline]. [Full Text].

  49. Joy TR, Hegele RA. Narrative review: statin-related myopathy. Ann Intern Med. 2009 Jun 16. 150(12):858-68. [Medline].

  50. Wiegman A, Hutten BA, de Groot E, Rodenburg J, Bakker HD, Büller HR, et al. Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized controlled trial. JAMA. 2004 Jul 21. 292(3):331-7. [Medline].

  51. Kao LW, Nañagas KA. Toxicity associated with carbon monoxide. Clin Lab Med. 2006 Mar. 26(1):99-125. [Medline].

  52. Aslam AF, Aslam AK, Vasavada BC, Khan IA. Hypothermia: evaluation, electrocardiographic manifestations, and management. Am J Med. 2006 Apr. 119(4):297-301. [Medline].

  53. Bergeron MF, McKeag DB, Casa DJ, Clarkson PM, Dick RW, Eichner ER, et al. Youth football: heat stress and injury risk. Med Sci Sports Exerc. 2005 Aug. 37(8):1421-30. [Medline].

  54. Hurley JK. Severe rhabdomyolysis in well conditioned athletes. Mil Med. 1989 May. 154(5):244-5. [Medline].

  55. Sinert R, Kohl L, Rainone T, Scalea T. Exercise-induced rhabdomyolysis. Ann Emerg Med. 1994 Jun. 23(6):1301-6. [Medline].

  56. Chen YJ, Chang SH, Yuan A, Huang CH, Lee CC. Rhabdomyolysis after successful resuscitation of a patient with near-fatal asthma. Am J Emerg Med. 2007 Jul. 25(6):736.e3-4. [Medline].

  57. Mehta R, Fisher LE Jr, Segeleon JE, Pearson-Shaver AL, Wheeler DS. Acute rhabdomyolysis complicating status asthmaticus in children: case series and review. Pediatr Emerg Care. 2006 Aug. 22(8):587-91. [Medline].

  58. Song SH, Lee DW, Lee SB, Kwak IS. Rhabdomyolysis caused by strenuous computer gaming. Nephrol Dial Transplant. 2007 Apr. 22(4):1263-4. [Medline].

  59. Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine (Baltimore). 2005 Nov. 84(6):377-85. [Medline].

  60. Wu CT, Huang JL, Lin JJ, Hsia SH. Factors associated with nontraumatic rhabdomyolysis and acute renal failure of children in Taiwan population. Pediatr Emerg Care. 2009 Oct. 25(10):657-60. [Medline].

  61. Chamberlain MC. Rhabdomyolysis in children: a 3-year retrospective study. Pediatr Neurol. 1991 May-Jun. 7(3):226-8. [Medline].

  62. Ward MM. Factors predictive of acute renal failure in rhabdomyolysis. Arch Intern Med. 1988 Jul. 148(7):1553-7. [Medline].

  63. Fernandez WG, Hung O, Bruno GR, Galea S, Chiang WK. Factors predictive of acute renal failure and need for hemodialysis among ED patients with rhabdomyolysis. Am J Emerg Med. 2005 Jan. 23(1):1-7. [Medline].

  64. Li SF, Zapata J, Tillem E. The prevalence of false-positive cardiac troponin I in ED patients with rhabdomyolysis. Am J Emerg Med. 2005 Nov. 23(7):860-3. [Medline].

  65. Baeza-Trinidad R, Brea-Hernando A, Morera-Rodriguez S, Brito-Diaz Y, Sanchez-Hernandez S, El Bikri L, et al. Creatinine as predictor value of mortality and acute kidney injury in rhabdomyolysis. Intern Med J. 2015 May 26. [Medline].

  66. Lappalainen H, Tiula E, Uotila L, Mänttäri M. Elimination kinetics of myoglobin and creatine kinase in rhabdomyolysis: implications for follow-up. Crit Care Med. 2002 Oct. 30(10):2212-5. [Medline].

  67. Minnema BJ, Neligan PC, Quraishi NA, Fehlings MG, Prakash S. A case of occult compartment syndrome and nonresolving rhabdomyolysis. J Gen Intern Med. 2008 Jun. 23(6):871-4. [Medline]. [Full Text].

  68. Young SE, Miller MA, Docherty M. Urine dipstick testing to rule out rhabdomyolysis in patients with suspected heat injury. Am J Emerg Med. 2009 Sep. 27(7):875-7. [Medline].

  69. Salluzzo R, Schwartz M,. Rhabdomyolysis. Emergency Clinical Practice. 4th ed. 1998. 2478-86.

  70. Moratalla MB, Braun P, Fornas GM. Importance of MRI in the diagnosis and treatment of rhabdomyolysis. Eur J Radiol. 2008 Feb. 65(2):311-5. [Medline].

  71. [Guideline] Finnish Medical Society Duodecim. Rhabdomyolysis. EBM Guidelines. Evidence-Based Medicine [Internet]. Helsinki, Finland: Wiley Interscience. John Wiley & Sons; 2007 Apr 12. [Full Text].

  72. Better OS, Stein JH. Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med. 1990 Mar 22. 322(12):825-9. [Medline].

  73. Iraj N, Saeed S, Mostafa H, Houshang S, Ali S, Farin RF, et al. Prophylactic fluid therapy in crushed victims of Bam earthquake. Am J Emerg Med. 2011 Sep. 29(7):738-42. [Medline].

  74. Gunn VL, Nechyba C, eds. The Harriet Lane Handbook. 16th ed. St Louis, MO: Mosby Elsevier, Inc.; 2002. 45:

  75. Brown CV, Rhee P, Chan L, Evans K, Demetriades D, Velmahos GC. Preventing renal failure in patients with rhabdomyolysis: do bicarbonate and mannitol make a difference?. J Trauma. 2004 Jun. 56(6):1191-6. [Medline].

  76. Sever MS, Vanholder R, Lameire N. Management of crush-related injuries after disasters. N Engl J Med. 2006 Mar 9. 354(10):1052-63. [Medline].

  77. Thoenes M. Rhabdomyolysis: when exercising becomes a risk. J Pediatr Health Care. 2010 May-Jun. 24(3):189-93. [Medline].

  78. Harding A. New risk score predicts outcome in rhabdomyolysis. Medscape Medical News. September 4, 2013. Available at http://www.medscape.com/viewarticle/810443. Accessed: September 9, 2013.

  79. McMahon GM, Zeng X, Waikar SS. A Risk Prediction Score for Kidney Failure or Mortality in Rhabdomyolysis. JAMA Intern Med. 2013 Sep 2. [Medline].

 
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Model of helical domains in myoglobin (protein linked to kidney damage in rhabdomyolysis).
 
 
 
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