A 20-YEAR EXPERIENCE OF RHABDOMYOLYSIS TREATMENT, COMPLICATED BY ACUTE RENAL FAILURE

Abstract

Aim. To analyze the efficacy of a 20-year experience of critical care of rhabdomyolysis with acute renal failure (ARF). Materials. 284 medical records of patients with compartment syndrome and great vessel thrombosis with rhabdomyolysis, accompanied by oliguric and anuric ARF were retrospectively reviewed. Patients with rhabdomyolysis, caused by trauma as well as somatic pathologies, were excluded. The complication rate was assessed; the quality and quantity of extracorporeal blood purification techniques were estimated as well as the access sites, the effectiveness of surgical procedures, mortality rates and their structure in a 10-year follow-up period (1993–2002 and 2003–2012). Results. Over the past decade, the number of patients remains stable; opiate coma is among common causes resulting in compartment syndrome. The reduction of time from the admission to the event development, improvement of extracorporeal blood purification technique and its early initiation as well as the refusal to perform fasciotomy have decreased the rate and severity of later complications. In the mortality structure endotoxic shocks have replaced later purulent-septic complications, the mortality rate decreased by 58.5%. Conclusion. The efficient algorithm of intensive care for oliguria and anuria has been found.