Electrical burn injury and rhabdomyolysis

Electrical burns account for 3-5% of burn admissions, with high morbidity and mortality due to deep muscle injury and systemic complications. Rhabdomyolysis is common and a major contributor to acute kidney injury and death.

To review the current evidence on the pathophysiology, systemic complications, diagnosis, and management of electrical burn injuries, with particular emphasis on rhabdomyolysis and its implications for intensive care management.

A structured narrative review of the literature on electrical burn injuries was conducted using PubMed, Embase, and Scopus, with a focus on rhabdomyolysis and its implications for acute kidney injury.

Rhabdomyolysis is a frequent event in patients with electrical burns and represents a major factor in the development of acute kidney injury. Creatine phosphokinase > 5000 IU/L and myoglobinuria are associated with an increased risk of renal complications. Early fluid resuscitation and prompt recognition of compartment syndrome improve outcomes. Evidence does not support routine use of alkalinization or mannitol. Renal replacement therapy should be guided by conventional indications for acute kidney injury, as current evidence does not support its prophylactic initiation.

Early identification of rhabdomyolysis and optimization of renal perfusion are critical. An evidence-based practical framework is presented.