A 62-year-old man is admitted to ICU with rhabdomyolysis following a prolonged collapse. CK is 85,000 U/L, creatinine 250 µmol/L, potassium 6.2 mmol/L...

Question

A 62-year-old man is admitted to ICU with rhabdomyolysis following a prolonged collapse. CK is 85,000 U/L, creatinine 250 µmol/L, potassium 6.2 mmol/L, calcium 1.8 mmol/L, phosphate 2.5 mmol/L. Urine output is 20 mL/hr. What is the most important initial intervention to prevent progression of AKI?

Accepted Answer

Aggressive IV crystalloid resuscitation aiming for urine output >200 mL/hr

Answer

IV sodium bicarbonate to alkalinise the urine to pH >6.5

Answer

Immediate initiation of haemodialysis

Answer

IV calcium gluconate for hyperkalaemia

Answer

IV mannitol 0.5 g/kg

uk-fficm MCQ (SBA): Rhabdomyolysis

A 62-year-old man is admitted to ICU with rhabdomyolysis following a prolonged collapse. CK is 85,000 U/L, creatinine 250 µmol/L, potassium 6.2 mmol/L, calcium 1.8 mmol/L, phosphate 2.5 mmol/L. Urine output is 20 mL/hr. What is the most important initial intervention to prevent progression of AKI?