tailieunhanh - Báo cáo khoa học: "Extracorporeal therapies in acute rhabdomyolysis and myoglobin clearance"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Extracorporeal therapies in acute rhabdomyolysis and myoglobin clearance. | Available online http content 9 2 141 Commentary Extracorporeal therapies in acute rhabdomyolysis and myoglobin clearance Claudio Ronco Department of Nephrology St Bortolo Hospital Vicenza Italy Corresponding author Claudio Ronco cronco@ Published online 8 February 2005 Critical Care 2005 9 141-142 DOI cc3055 This article is online at http content 9 2 141 2005 BioMed Central Ltd See related research by Naka et al. in this issue http content 9 2 R90 and review page 158 http content 9 2 158 Abstract Rhabdomyolysis is a pathogenetic cause of acute kidney injury. In such circumstances not only should therapeutic strategies to replace the failing kidney be implemented but measures should also be explored to prevent further damage by circulating myoglobin. Volume expansion and forced diuresis have been used but when a kidney fails renal replacement therapies are instituted. The techniques and devices used for classic dialytic techniques have displayed a limited capacity for the removal of circulating myoglobin. In a recent paper Naka and colleagues have proposed the use of a super-high-flux membrane in continuous hemofiltration. The removal of myoglobin was greater than in than any previous report. Thus if the removal of myoglobin is desirable a combination of continuous hemofiltration and hyperpermeable membranes seems to be the most effective. However care must be exercised to prevent unwanted albumin losses. Rhabdomyolysis is a pathogenetic cause of acute kidney injury in a large number of cases where traumatic or non-traumatic causes induce muscle cell disruption 1 . Naka and colleagues concluded an interesting study on myoglobin clearance by hemofiltration using a super-high-flux membrane in a case of acute rhabdomyolysis 2 . The paper is of peculiar interest for several reasons. First because of the renal damage induced by circulating myoglobin not only should therapeutic strategies be implemented to