Abstract | BACKGROUND: METHODS: This study was a review of all adult trauma intensive care unit (ICU) admissions over 5 years (January 1997-September 2002). Creatine kinase (CK) levels were checked daily (abnormal,>520 U/L). RF was defined as a creatinine greater than 2.0 mg/dL. Patients received BIC/MAN on the basis of the surgeon's discretion. RESULTS: Among 2,083 trauma ICU admissions, 85% had abnormal CK levels. Overall, RF occurred in 10% of trauma ICU patients. A CK level of 5,000 U/L was the lowest abnormal level associated with RF; 74 of 382 (19%) patients with CK greater than 5,000 U/L developed RF as compared with 143 of 1,701 (8%) patients with CK less than 5,000 U/L (p < 0.0001). Among patients with CK greater than 5,000 U/L, there was no difference in the rates of RF, dialysis, or mortality between those who received BIC/MAN and those who did not. Subanalysis of groups with various levels of CK still failed to show any benefit of BIC/MAN. CONCLUSION: Abnormal CK levels are common among critically injured patients, and a CK level greater than 5,000 U/L is associated with RF. BIC/MAN does not prevent RF, dialysis, or mortality in patients with creatine kinase levels greater than 5,000 U/L. The standard of administering BIC/MAN to patients with post-traumatic rhabdomyolysis should be reevaluated.
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Authors | Carlos V R Brown, Peter Rhee, Linda Chan, Kelly Evans, Demetrios Demetriades, George C Velmahos |
Journal | The Journal of trauma
(J Trauma)
Vol. 56
Issue 6
Pg. 1191-6
(Jun 2004)
ISSN: 0022-5282 [Print] United States |
PMID | 15211124
(Publication Type: Journal Article)
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Chemical References |
- Diuretics, Osmotic
- Mannitol
- Sodium Bicarbonate
- Creatine Kinase
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Topics |
- Acute Kidney Injury
(blood, etiology, prevention & control)
- Creatine Kinase
(blood)
- Diuretics, Osmotic
(administration & dosage, therapeutic use)
- Drug Therapy, Combination
- Female
- Humans
- Logistic Models
- Male
- Mannitol
(administration & dosage, therapeutic use)
- Middle Aged
- Odds Ratio
- Rhabdomyolysis
(blood, complications)
- Risk Factors
- Sodium Bicarbonate
(administration & dosage, therapeutic use)
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