Understanding the Syndrome, Complications, and Nursing Considerations
Mild muscle pain can be a common side effect of physical means, such as intense workouts, over usage of muscle, and/or blocked blood vessels, or by chemical means, such as toxins, heat or drugs. Oftentimes, people who experience muscle aches can easily pinpoint the cause due to their knowledge of the stress, tension, or physical activity they have endured. Rhabdomyolysis, or dissolution of skeletal muscle, is a syndrome caused by injury to skeletal muscle and involves the leakage of large quantities of potentially toxic intracellular contents into plasma (Muscal, 2013). In contrast to mild muscle pain, Rhabdomyolysis, commonly known as ‘Rhabdo’, may result in life-threatening renal failure and disseminated intravascular coagulation (DIC) while also being multifactorial in adult patients (Muscal, 2013). Approximately 28-37% of all Rhabdomyolysis cases in the United States require short term hemodyalysis (Melli G, 2013). The purpose of this paper is to explore the causes, signs and symptoms, nursing considerations and workout trends that are being blamed for inducing ‘Rhabdo’ in athletes.
According to the National Discharge Survey, there are approximately 26,000 cases of Rhabdomyolysis that are reported throughout the United States annually (Melli G, 2013). Sixty percent of these cases in adults include multiple factors such as trauma and compression leading to direct muscle injury, occlusion of vessels from thromboemboli or surgical clamping, prolonged immobilization, burns and fractures. However, Rhabdomyolysis in pediatric patients is often caused from infections, trauma, metabolic conditions and muscle diseases. (Mannix R, 2006). The overall mortality for patients with Rhabdomyolysis is approximately five percent; however, the risk of death for any single patient is dependent on the underlying etiology and any existing co-morbid conditions that may be present (Muscal, 2013).
Process of Rhabdomyolysis
As previously stated Rhabdomyolysis can be caused from numerous injuries but it is ultimately the breakdown of muscle tissue that leads to life threatening conditions such as Acute Renal Failure. The process of muscle breakdown leads to depletion of Adenosine Triphosphate, which is where muscles receive their energy, and increased levels of potassium, creatine kinase, urate and myoglobin (Sauret, 2002). In addition to electrolyte disturbances causing toxicity leading to the breakdown of muscle tissue, the increase number of neutrophils from the inflammatory process amplifies muscle damage (Muscal, 2013). Acute Kidney Failure occurs because the increased levels of myoglobin, a large protein, that precipitates in the kidney tubules leading to obstruction that eventually leads to necrosis (Sauret, 2002).
Causes of Rhabdomyolysis
Although there are myriad causes of Rhabdomyolysis, the most common causes include the usage of alcohol or illicit...