Document Detail


The effect of combining intermittent hemodiafiltration with forced alkaline diuresis on plasma myoglobin in rhabdomyolysis.
MedLine Citation:
PMID:  17430315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Our aim was to examine the effect of combining intermittent hemodiafiltration (HDF) with forced alkaline diuresis on plasma myoglobin in rhabdomyolysis. METHODS: This was a prospective, randomized, controlled, cross-over study. Sixteen rhabdomyolysis patients with plasma myoglobin concentrations above 10,000 microg/l were randomized. Forced alkaline diuresis was started immediately after allocation and continued throughout the study. HDF, which lasted for 4 h, was started in group A immediately after allocation and in group B 4 h later. The primary analysis was intention-to-treat by repeated measures analysis of variance and Mann-Whitney U-test. RESULTS: The percentage elimination of myoglobin from the circulation during HDF differed significantly from that during alkaline diuresis (28.1% vs. 14.2%, respectively; P < 0.01). The mean decrease in plasma myoglobin concentration during HDF [9731 microg/l; 95% confidence interval (CI), 3672-5345 microg/l] and forced alkaline diuresis (3646 microg/l; 95% CI, 1260-6032 microg/l) did not show a statistically significant difference (P= NS). The mean total amount of myoglobin found in the ultrafiltrate was 58.4 mg. CONCLUSION: The percentage myoglobin decrease during combined HDF and forced alkaline diuresis was higher than that during forced alkaline diuresis alone. Renal replacement therapy with filtration techniques may be considered for the clearance of myoglobin from plasma when urine alkalinization is not successful.
Authors:
S Peltonen; A Ahlström; V Kylävainio; E Honkanen; V Pettilä
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  51     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-13     Completed Date:  2007-07-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  553-8     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Cross-Over Studies
Diuresis
Female
Fluid Therapy / methods*
Hemodiafiltration / instrumentation,  methods*
Humans
Male
Middle Aged
Myoglobin / blood*
Prospective Studies
Rhabdomyolysis / blood,  therapy*
Sodium Bicarbonate / therapeutic use
Sodium Chloride / therapeutic use
Chemical
Reg. No./Substance:
0/Myoglobin; 144-55-8/Sodium Bicarbonate; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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