Massive rhabdomyolysis following cardiopulmonary bypass.
Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.
Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University School of Medicine, Korea.
Young Sam
YS
Kim
Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University School of Medicine, Korea.
Yong Han
YH
Yoon
Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University School of Medicine, Korea.
Joung Taek
JT
Kim
Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, Inha University School of Medicine, Korea.
Wan Ki
WK
Baek
Cardiopulmonary bypass; Malignant hyperthermia; Rhabdomyolysis