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Published on: August 9, 2013
The Use of Coupled Plasma Filtration Adsorption in Traumatic Rhabdomyolysis
Mario Pezzi1, Silvia Renda1, Anna Maria Giglio1
1Anaesthesia and Intensive Care Unit, General Hospital "Pugliese-Ciaccio", Viale Pio X, 88100 Catanzaro, Italy.
Abstract:
Severe musculoskeletal injuries induce the release of sarcoplasmic elements such as muscle enzymes, potassium, and myoglobin in the systemic circulation. The circulating myoglobin damages the glomerulus and renal tubules. Conventional haemodialysis is not able to remove myoglobin, due to its high molecular weight (17,8 kilodaltons [kDa]). We treated four traumatic rhabdomyolysis patients with Coupled Plasma Filtration Adsorption (CPFA) in order to remove myoglobin followed by 14 hours of Continuous Veno-Venous Hemofiltration (CVVH). During the treatment, all patients showed clinical improvement with a decrease in muscular (creatine kinase [CK] and myoglobin) and renal (creatinine and potassium) damage indices. One patient, in spite of full renal recovery, died of cerebral haemorrhage on the 26th day of hospital stay.
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