title: Rhabdomyolysis in Critically Ill Surgical Patients.
abstract: BACKGROUND
  Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication.
  
  
  OBJECTIVE
  of this study is to detect the incidence of rhabdomyolysis in critically ill patients in the surgical intensive care unit (ICU), and to raise awareness of this medical condition and its treatment among the clinicians.
  
  
  METHODS
  A retrospective review of all surgical and trauma patients admitted to surgical ICU of the University Surgical Clinic "Mother Teresa" in Skopje, Macedonia, from January 1sttill December 31st2015 was performed. Patients medical records were screened for available serum creatine kinase (CK) with levels > 200 U/l, presence of myoglobin in the serum in levels > 80 ng/ml, or if they had a clinical diagnosis of rhabdomyolysis by an attending doctor. Descriptive statistical methods were used to analyze the collected data.
  
  
  RESULTS
  Out of totally 1084 patients hospitalized in the ICU, 93 were diagnosed with rhabdomyolysis during the course of one year. 82(88%) patients were trauma patients, while 11(12%) were surgical non trauma patients. 7(7.5%) patients diagnosed with rhabdomyolysis developed acute kidney injury (AKI) that required dialysis. Average values of serum myoglobin levels were 230 ng/ml, with highest values of > 5000 ng/ml. Patients who developed AKI had serum myoglobin levels above 2000 ng/ml. Average values of serum CK levels were 400 U/l, with highest value of 21600 U/l. Patients who developed AKI had serum CK levels above 3000 U/l.
  
  
  CONCLUSIONS
  Regular monitoring and early detection of elevated serum CK and myoglobin levels in critically ill surgical and trauma patients is recommended in order to recognize and treat rhabdomyolysis in timely manner and thus prevent development of AKI.
authors.affiliation: Universty Clinic for Anesthesiology, Reanimation and Intensive Care Medicine, Clinical Campus "Mother Teresa", Skopje, Macedonia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Kuzmanovska
authors.affiliation: University Clinic for Neurology, Clinical Campus "Mother Teresa", Skopje, Macedonia.
authors.forename: Emilija
authors.initials: E
authors.lastname: Cvetkovska
authors.affiliation: University Clinic for Neurology, Clinical Campus "Mother Teresa", Skopje, Macedonia.
authors.forename: Igor
authors.initials: I
authors.lastname: Kuzmanovski
authors.affiliation: University Clinic for Digestive Surgery, Clinical Campus "Mother Teresa", Skopje, Macedonia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Jankulovski
authors.affiliation: University Surgical Clinic "St Naum Ohridski", Skopje, Macedonia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Shosholcheva
authors.affiliation: Universty Clinic for Anesthesiology, Reanimation and Intensive Care Medicine, Clinical Campus "Mother Teresa", Skopje, Macedonia.
authors.forename: Andrijan
authors.initials: A
authors.lastname: Kartalov
authors.affiliation: Universty Clinic for Anesthesiology, Reanimation and Intensive Care Medicine, Clinical Campus "Mother Teresa", Skopje, Macedonia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Spirovska
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018843:Republic of North Macedonia; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult
keywords: critical illness; rhabdomyolysis