Rhabdomyolysis, associated with more than 100 conditions, is due to destruction of skeletal muscle cells and leakage of intracellular contents into the circulation. Treatment consists of early detection, aggressive fluid replacement, alkaline diuresis, and management of complications.

Despite their highly varied histories, profound rhabdomyolysis developed in each of the critically ill patients described in the “Patient Profiles” (see box). What is rhabdomyolysis? Why does it occur in such dissimilar populations? Which patients are at risk? What are the signs and symptoms? And how is it treated?

Myo refers to muscle, rhabdo means striated (as in striated or skeletal muscle), and lysis is breakdown. Therefore, rhabdomyolysis (pronounced rab′-do-mi-ol′-i-sis)1 is a dissolution of skeletal muscles that produces a nonspecific clinical syndrome that causes extravasation of toxic intracellular contents from the myocytes into the circulatory system. Regardless of the initial precipitating factor, leaky skeletal muscle cells constitute the common rhabdomyolysis pathway....

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