Rhabdomyolysis: what it is, causes, symptoms, treatment of ailment

The consequences of muscle injury are well known to people involved in professional sports. Those who receive constant physical activity and have an idea of ​​their benefits and harm, are familiar with the concept of "rhabdomyolysis".Symptoms of this disease are very serious. Despite the mild course, pathology can lead to terrible consequences for the body. Rhabdomyolysis - what is it? This question can be answered not only by the doctor, but also by any qualified coach for each of the sports. Pathology is very dangerous and can lead to death if a severe stage occurs. Nevertheless, if it is found on time, a complete cure is possible. Rhabdomyolysis - what is it?

This pathology is most often observed with muscle injuries. It involves the destruction of tissue and the release of harmful substances into the blood. So, in a nutshell, you can describe the essence of the syndrome called rhabdomyolysis. What is it, will become more understandable if we study the development of the disease and the consequences of this for the body. It should be remembered that not every trauma or physical strain leads to a disease. Rhabdomyolysis is a syndrome in which the destruction of muscle tissue occurs. As a result of the destruction of skeletal muscles, a substance enters the bloodstream, which normally should not be present. It is a protein called myoglobin. It is an essential component for muscles. Normally inactivated by the kidneys and does not harm the body. But with the destruction and breakdown of muscles, its amount in the blood reaches a high concentration. As a result, myoglobin circulates through the body for a long time, releasing nephrotoxic free radicals. These substances are extremely harmful to the tissues of the renal tubules. Proceeding from this, it is possible to answer the question: "Rhabdomyolysis - what is it and how dangerous is it?"In addition to the destruction of muscles, this syndrome can lead to such a serious condition as acute renal failure. In case of untimely assistance, the OPN is capable of causing a fatal outcome.

Rhabdomyolysis: causes of the disease

There are 2 groups of causes leading to the development of rhabdomyolysis. In the first case, these are skeletal muscle injuries. They do not include minor effects on the muscles( bruises).Among the damaging factors are:

1. Heavy accidents.
2. Large in area and depth of burns( reaching the muscle layer).
3. Effect of electric current on the body.
4. Violent actions that lead to musculoskeletal injuries.
5. Toxicosis caused by traumatic shock.
6. Prolonged surgical interventions.

Another cause of rhabdomyolysis are severe contractions of muscle tissue. They can lead to heavy physical exertion( unusual for the body), convulsive syndrome.

In addition, there are other factors that lead to rhabdomyolysis. They are less common, but still can cause the development of this pathology. These include the violation of electrolyte balance, bacterial and viral diseases, as well as drug intoxication. All these factors contribute to the deficiency of ATP.As you know, it is the deficiency of this substance that affects the development of rhabdomyolysis. A small amount of ATP causes a decrease in electrolytes in the body. These include substances such as calcium, phosphate and potassium. The lack of these substances is observed with heat and sun impact, hypothermia. In some cases, the destruction of muscle tissue leads to a prolonged stay of a person in a lying position - immobilization.

Mechanism of development of rhabdomyolysis

The pathogenesis of rhabdomyolysis depends on the cause of the destruction of the skeletal musculature. If the muscles were damaged by traumatic effects or a metabolic disorder, then the cells swell. This happens due to the entry of fluid from the surrounding space into the membrane of myocytes. Due to this disorder, the cells swell and become large. Changed myocytes press on surrounding tissues and nerve fibers. Thus, the flow of blood to healthy muscle cells is disrupted, which leads to their destruction. Due to the destruction of skeletal muscles, the release of protein - myoglobin. In general, this substance is not toxic to the body. Nevertheless, the protein can cause disruption of the kidneys. This happens in the following way: myoglobin binds to the substance present in the kidney cells. This compound leads to the formation of solid formations that interfere with the flow of blood. In addition, myoglobin has a nephrotoxic effect.

Clinical signs of pathology

Highlights severe and mild symptoms of rhabdomyolysis. In the first case, the syndrome of muscle destruction is combined with renal failure. Rhabdomyosis is not heavily burdened with arthritis. The clinical manifestations of pathology include:

1. Muscular weakness.
2. Darkening of the color of urine. This sign indicates a violation of kidney function and is a diagnostic criterion for rhabdomyolysis. Edema and soreness of skeletal muscles.

When the renal failure is connected, the patient's condition deteriorates sharply. Symptoms of ARF include:

1. Limb edema.
2. Small discharge of urine, right up to her absence.
3. Compression syndrome. It is due to the swelling of the muscle tissue. May lead to squeezing of vital organs. Symptoms of this disorder are: shortness of breath, lowering of blood pressure, shock.
4. Tachycardia, in the following - a thread-like pulse.
5. Violation of electrolyte balance.
6. Comatose state.

Diagnostic criteria for rhabdomyolysis

It is possible to suspect the disease by the following criteria: the transferred trauma of the muscular tissue, soreness and edema of the musculature, darkening of the urine. These symptoms make it possible to put a preliminary diagnosis of "rhabdomyolysis".The disease is always accompanied by changes in blood and urine. The diagnosis is confirmed if the following abnormalities are detected in laboratory studies:

1. Increased level of creatine phosphokinase.
2. The appearance in the blood of myoglobin.
3. Increase in phosphorus and potassium levels, decrease in calcium ions.
4. With the development of renal failure - a large amount of creatinine and urea.
5. Myoglobinuria( the appearance of protein in the urine).

In addition, changes are observed on the ECG( expansion of ventricular complexes, the appearance of T-waves).With a pronounced compression syndrome, there may be damage to internal organs, bones. Therefore, for the diagnosis of violations it is necessary to conduct X-rays.

Methods for treating rhabdomyolysis

The patient should be assisted immediately, immediately after the diagnosis of rhabdomyolysis. Treatment of pathology should be carried out in a hospital, since in hospital conditions it is possible to monitor the level of electrolytes. For the purification of the body, rehydration is carried out. In the case of severe rhabdomyolysis, infusion therapy with physiological saline is necessary. Correction of water-salt and electrolyte metabolism is also important. To normalize diuresis, diuretic drugs "Furosemide" or "Mannitol" are administered. In extremely severe cases, hemodialysis is used. If the muscle pressure reaches more than 30 mm.gt;Art., surgical excision of tissues is necessary - fasciotomy. Only in this way can the cessation of further compression of organs be achieved.

Possible complications of pathology

It should be noted that timely assistance with a mild degree of pathology will help stop rhabdomyolysis. Photos of patients suffering from this syndrome are abundantly represented on the pages of relevant information resources of medical topics. Know how the affected muscles look is very important to people engaged in heavy physical labor. In case of suspicion of rhabdomyolysis, it is necessary to conduct laboratory tests of blood and urine. If the disease has developed to a severe degree, it is dangerous for the following complications:

1. Damage to organs and tissues. It arises because of the syndrome of compression.
2. Acute renal failure.
3. DIC-Syndrome. Occurs because of poor blood clotting. In severe cases, it leads to death.

Prognosis for life in rhabdomyolysis

The prognosis depends on the severity of the pathology. At the initial stage, the disease is well suited for drug treatment. Relapses are observed only in case of repeated traumatization. If the pathology has reached a severe degree, the prognosis is less favorable. Nevertheless, the cure is possible with a combination of drug therapy and surgical intervention. In the case of development of arrester, the death rate is 20%.