Traumatic rhabdomyolysis: Electrolyte changes

Abstract

Severe electrolyte disturbances occur in traumatic rhabdomyolysis (crush syndrome) developing after disasters such as earthquakes. The purpose of this study is to examine the long-term course of these electrolyte abnormalities. Patients followed up in intensive care for at least 10 days due to post-earthquake crush syndrome were included in the study. Their demographic data and sodium, potassium, calcium, and phosphorus levels over the course of 10 days were retrieved retrospectively and recorded. Fifteen out of 23 patients with crush syndrome were enrolled in the study. The dominant electrolyte abnormalities in the first three days of hospitalization were normonatremia, hyperpotassemia, hypocalcemia, and hyperphosphatemia. No change in normonatremia was observed at the end of the 10th day, but hyperpotassemia gave way to normo- and hypokalemia, and hyperphosphatemia to normophosphatemia. Although hypocalcemia was less prevalent and not as deep as in the first five days, it was still the dominant calcium disorder at the end of the 10th day. Crush syndrome can be linked to severe electrolyte abnormalities. These electrolytes may be hypo or hyper in form at the onset of crush syndrome but can reverse in the opposite direction, or an existing abnormality may become more profound during follow-up. Knowing the direction assumed by electrolyte abnormalities, and on which days, will therefore be more beneficial for patient management.