IBCC Episode 37 - Rhabdomyolysis

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam delve into the complexities of rhabdomyolysis, a condition often oversimplified. They highlight the lack of solid evidence in treatment approaches, emphasizing the importance of identifying underlying causes such as physical injury, excessive muscle activity, and electrolyte abnormalities. The discussion covers lab clues, including electrolyte imbalances and disproportionately elevated AST levels, as well as the unreliability of traditional symptoms in ICU patients. They introduce the McMahon Rhabdomyolysis score as a tool for risk stratification and guide treatment decisions, particularly regarding fluid management, advocating for a balanced approach of "lending" fluids rather than aggressively administering them. The hosts also address the type of fluid, when to stop fluid administration, and debunk the myth of dialysis for myoglobin removal, concluding with an algorithm for risk stratification and treatment based on the McMahon score.