The Use of Coupled Plasma Filtration Adsorption in Traumatic Rhabdomyolysis

Severe musculoskeletal injuries induce the release of sarcoplasmic elements such as muscle enzymes, potassium, and myoglobin in the systemic circulation. The circulating myoglobin damages the glomerulus and renal tubules. Conventional haemodialysis is not able to remove myoglobin, due to its high mo...

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Published inCase Reports in Critical Care Vol. 2017; no. 2017; pp. 1 - 8
Main Authors Verre, Mario, Casella, Patrizia Dina, Tiburzi, Simona Paola, Scozzafava, Annamaria, Giglio, Anna Maria, Renda, Silvia, Pezzi, Mario, Iannelli, Fabrizio
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 01.01.2017
Hindawi
John Wiley & Sons, Inc
Hindawi Limited
Subjects
Adsorption
Apheresis
Blood
Care and treatment
Case Report
Case studies
Hemodialysis
Patients
Plasma
Potassium
Rhabdomyolysis
Urine
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Summary:Severe musculoskeletal injuries induce the release of sarcoplasmic elements such as muscle enzymes, potassium, and myoglobin in the systemic circulation. The circulating myoglobin damages the glomerulus and renal tubules. Conventional haemodialysis is not able to remove myoglobin, due to its high molecular weight (17,8 kilodaltons [kDa]). We treated four traumatic rhabdomyolysis patients with Coupled Plasma Filtration Adsorption (CPFA) in order to remove myoglobin followed by 14 hours of Continuous Veno-Venous Hemofiltration (CVVH). During the treatment, all patients showed clinical improvement with a decrease in muscular (creatine kinase [CK] and myoglobin) and renal (creatinine and potassium) damage indices. One patient, in spite of full renal recovery, died of cerebral haemorrhage on the 26th day of hospital stay.
Bibliography:Academic Editor: Nicolas Nin
ISSN:2090-6420
2090-6439
DOI:10.1155/2017/5764961