Díaz OO, Pizańa DA, Chávez SJMJ, Morales CI

Language: Spanish
References: 19
Page: 141-148
PDF size: 160.25 Kb.

ABSTRACT

Introduction: Rabdomyolysis (R) consists of the anomalous release of proteins due to destruction of skeletal muscle tissue. It produces diverse effects and can lead to acute renal failure (ARF). Rabdomyolysis has been widely in the literature as a consequence of different problems, essentially politrauma. Surgery with spinal column instrumentation implies manipulating large masses of muscle with the patient remaining in forced positions for long periods of time; also, there is frequently abundant bleeding. All these are conditions that generate hypoxia and muscle destruction with the possibility of releasing myoglobin and producing R. Objectives: Illustrate the appearance of R in the post-operatory period of spinal column surgery. Material and methods: Five cases are presented, in all of them the presence of myoglubinemia was demonstrated with CPK elevation and an increase in the color of the urine. Results: In every case and insufficient volume input was shown during the trans-operatory period with prolonged surgical times. Volume restitution and HCO₃ restoration were carried out. Only one patient had ARF and died. The remaining patients were egressed from the hospital because they got better. Conclusion: Present concepts on the physiopathology, etiology, diagnosis and treatment of rabdomyolisis are analyzed and we propose that the best strategy to prevent R is with appropriate volume restitution and oxygenation.

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