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Rhabdomyolysis in pediatric trauma patients in an intensive care unit

Raquel Lopes de Bragança, Mariana Ferreira, Sara Catarino, Marta Grilo, Carolina Baptista, Augusto Ribeiro.

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Rhabdomyolysis is a potentially life-threatening condition that can have significant consequences, such as acute kidney injury. There are few studies assessing rhabdomyolysis in children following trauma. We intent to characterize rhabdomyolysis and its outcomes in trauma patients admitted to a pediatric intensive care unit. A retrospective study was conducted in an urban trauma centre. In four years, ninety-five pediatric trauma patients were admitted to intensive care. In 35 (36.8%) cases, creatine kinase levels were not assessed. Of the remaining 60, rhabdomyolysis was present in 29 (48.3%). Symptoms were present in two cases. Six patients (20.7%) developed subsequent acute kidney injury, and one patient required venous hemodiafiltration. Three patients died from other complications, and none developed chronic kidney disease.
Rhabdomyolysis is a frequent complication of trauma and should be assessed systematically in pediatric trauma patients requiring intensive care. Acute kidney injury is an important complication of rhabdomyolysis, although its incidence in children may be smaller. Higher creatinine levels on admission and Pediatric Risk of Mortality scores were predictive of renal impairment in rhabdomyolysis patients.

Key words: acute kidney injury, creatine kinase, intensive care, pediatric, rhabdomyolysis

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