Rhabdomyolysis and Hepatic Injury

In the setting of major trauma, rhabdomyolysis can occur and leads a host of physiologic derangements including acidosis, electrolyte disturbances, coagulation abnormalities, and thrombotic complications. Patients are at high risk for end organ damage, most commonly renal failure. Investigators in this issue of Anesthesia & Analgesia explore whether rhabdomyolysis also implicates the development of hepatic dysfunction and failure. Two hundred and seventy two patients at a major trauma center who were transfused within 24 hours after severe injury were characterized as having severe rhabdomyolysis. This was defined by a CK level greater than 5000 U/L. These patients were noted to have statistically significant elevations in ALT and AST. Patients with a greater severity of rhabdomyolysis were more likely to develop hepatic failure. Future studies will elucidate and risk-stratify this relationship. The reader is encouraged to review the cited article for an in-depth understanding of the concepts summarized in this infographic.