Title: Rhabdomyolysis in the Critically Ill
题目：危重病人中的横纹肌溶解症
Author 作者: Michael Winters

Rhabdomyolysis can be disastrous in the critically ill patient, resulting in metabolic acidosis, life-threatening hyperkalemia, acute kidney injury, and acute renal failure (ARF).  In fact, mortality can be as high as 60% for those that develop ARF secondary to rhabdomyolysis.
横纹肌溶解症在危重病人中可能是灾难性的，导致代谢性酸中毒，危及生命的高钾血症，急性肾损伤和急性肾功能衰竭（ARF）。实际上，横纹肌溶解症导致急性肾功能衰竭的死亡率可高达60％。
Although creatine kinase (CK) is a sensitive marker of muscle injury and used for diagnosis, it is actually the presence of myoglobinuria that results in ARF.
虽然肌酸激酶（CK）是肌肉损伤的敏感标志，可用于诊断，但实际上是肌红蛋白尿导致ARF。
Current guidelines recommend treatment when the CK level is > 5000 U/L.
目前的指南建议CK水平> 5000 U / L时要进行治疗。
The mainstay of treatment remains aggressive fluid resuscitation with crystalloids.
主要的治疗措施仍然是用晶体液积极进行液体复苏。
The administration of bicarbonate to alkalinize the urine, diuretics to increase urine output, and osmotic agents (mannitol) to augment urine output remain controversial and are not supported by current literature.
碳酸氢钠碱化尿液，利尿剂及渗透剂（甘露醇）以增加尿量的方法仍然存有争议，目前的文献还没有支持证据。

References 参考文献：

Shapiro ML, Baldea A, Luchette FA. Rhabdomyolysis in the Intensive Care Unit. J Intensive Care Med 2012; 27:335-342.