Rhabdomyolysis: What you need to know

Rhabdomyolysis is a clinical syndrome characterized by the breakdown of skeletal muscle fibers and the subsequent release of intracellular contents into the circulation. Severe rhabdomyolysis can lead to life-threatening systemic complications, including acute kidney injury, extremity compartment syndrome, and disseminated intravascular coagulation. Despite decades of research, several important aspects of rhabdomyolysis remain controversial. There is currently no universally accepted definition of the syndrome, and substantial variability exists regarding the diagnostic CK threshold. Similarly, the optimal management strategies remain a subject of ongoing debate. For trauma and acute care surgeons, management extends beyond the diagnosis of muscle injury and often requires timely decisions regarding resuscitation, monitoring for evolving organ dysfunction, and the recognition of patients who may require urgent surgical intervention. This review provides a practical overview of rhabdomyolysis for trauma and acute care surgeons and aims to support clinicians in the timely evaluation and treatment of patients with rhabdomyolysis.