What is the primary treatment approach for rhabdomyolysis?

The primary treatment approach for rhabdomyolysis focuses on aggressive fluid resuscitation, which is essential for maintaining adequate kidney perfusion and preventing acute kidney injury that can occur as a complication of this condition. Intravenous fluids help dilute the myoglobin released from damaged muscle cells, promote renal excretion of myoglobin, and support urinary output.

In addition to fluids, bicarbonate may be administered to alkalinize the urine, which helps reduce the nephrotoxic effects of myoglobin. The use of calcium can help counteract potential hypocalcemia that may arise due to muscle breakdown and contributes to muscle function and excitation-contraction coupling.

Other options, such as surgical intervention or antibiotics, do not directly address the underlying process of rhabdomyolysis and its complications. Rest and ice may provide symptomatic relief for muscle discomfort but do not treat the metabolic and renal derangements associated with the condition. Diuretics, while sometimes used to maintain urine output, are not the primary treatment modality and can have variable effects.

This multifaceted treatment plan is vital for ensuring the best possible outcome for patients experiencing rhabdomyolysis.