title: Salvage of severe ischemic lower limb having peak creatine phosphokinase level exceeding 200,000 IU/L treated by continuous hemodiafiltration.
abstract: We performed revascularization by an anti-anatomical bypass in a 40-year-old man with extended ischemia of both legs beyond 12 hr after onset because of traumatic aortic dissection. This patient developed myonephropathic metabolic syndrome, including renal and circulatory failure accompanied by a creatine phosphokinase level above 200,000 IU/L. Nevertheless, his bilateral affected limbs were salvaged by intensive care based on aggressive hemocatharsis with continuous hemodiafiltration with treatment for poor hemodynamics and respiratory distress.
authors.affiliation: Department of Cardiovascular Surgery, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan. Electronic address: i.kashima@ashikaga.jrc.or.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kashima
authors.affiliation: Department of Cardiovascular Surgery, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Tsutsumi
authors.affiliation: Department of Cardiovascular Surgery, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okamoto
mesh_terms: D000058:Accidental Falls; D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy; D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D003131:Combined Modality Therapy; D003402:Creatine Kinase / Q000097:blood*; D017583:Hemodiafiltration; D006801:Humans; D007511:Ischemia / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed
chemical_list: D003402:Creatine Kinase