What is the treatment for rhabdomyolysis?
The treatment of rhabdomyolysis is primarily directed at preserving renal function. Ideal treatment involves early and aggressive hydration with very large amounts of IV fluids to flush the myoglobin out of the kidneys. Diuretics may help. So may bicarbonate which makes the urine alkaline to prevent the breakdown of myoglobin into more toxic compounds. Early and aggressive hydration may prevent complications by rapidly eliminating the myoglobin out of the kidneys. The hydration needs with muscle necrosis may approximate the massive fluid volume needs of a severely burned patient. This may involve intravenous administration of several liters of fluid until the condition stabilizes. Diuretic medications such as mannitol or furosemide may aid in flushing the pigment out of the kidneys. If the urine output is sufficient, bicarbonate may be given to maintain an alkaline urine state. This helps to prevent the dissociation of myoglobin into toxic compounds.
