Rehydration

The condition leading to rhabdomyolysis must be managed. Particular caution must be directed towards compartment syndromes that are commonly present in patients with rhabdomyolysis.

The cornerstone of management is aggressive intravascular fluid rehydration. The sooner this commences the lower the risk of developing renal failure. Ideally rehydration commences pre-hospitally at the same time as extrication.

In significant rhabdomyolysis it may be necessary to administer up to 10 litres of fluid.

No specific fluid algorithms exist and attention must be paid to strict fluid balance, urine output and serial monitoring of renal function and acid base status.