Severe Shivering on Venoarterial Extracorporeal Membrane Oxygenation—Raising the Circuit Temperature to Stop Rhabdomyolysis: A Case Report

Kadar, Rachel; Atassi, Giancarlo; Jarzebowski, Mary; Ault, Michael L.

doi:10.1213/xaa.0000000000001341

Cited by 2 publications

(3 citation statements)

References 14 publications

(12 reference statements)

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“…The McMahon Score is a predictive value used to estimate kidney failure and mortality in patients older than 18 years old and with CK level of at least 5000 U/L within 72 hours of admission. It also aids in early recognition and intervention that may reduce morbidity and mortality [9]. It is based on eight variables: age, gender, admission serum creatinine, admission CK, calcium, phosphate, bicarbonate, and etiology not due to seizure, syncope, exercise, statin use, or myositis [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…In an effort to combat an infection, the body induces a fever by increasing its thermoregulatory set point within the hypothalamus. Specifically, the preoptic area (POA) receives thermosensory information and relays signals to effector organs that elicit shivering and thermogenesis to increase the body's temperature to its new goal point [9,[16][17][18][19].…”

Section: Case Reportmentioning

confidence: 99%

“…Non-traumatic exertional rhabdomyolysis can occur in the presence of normal muscle integrity in which there is less supply for the excessive demand put on the muscle function. These are seen in long-distance runners, untrained athletes, and in ethnic black men with sickle cell trait with physical activities [8] and in hyperkinetic states such as grand mal seizures, delirium tremens, thermal extremes, severe agitation, and shivering [9,10]. When associated with inheritable muscle disorders of glycogenolysis, glycolysis, and lipid metabolism, recurrent episodes are common.…”

Section: Introductionmentioning

confidence: 99%

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A case of rhabdomyolysis with rigors

Bliss

Vellani

Spencer

et al. 2022

Int J Case Rep Images

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Introduction: Rhabdomyolysis is a potential life-threatening condition caused by extensive skeletal muscle breakdown with leakage of toxic muscle contents into the circulation. The most dreaded complication is acute renal failure caused by toxic effects of myoglobin in the kidneys. The causes of rhabdomyolysis are classified into traumatic, non-traumatic exertional, and non-traumatic rhabdomyolysis. The pathophysiologic hallmark of rhabdomyolysis regardless of etiology is increased free ionized calcium due to cellular energy depletion (ATP) or direct plasma membrane rupture and consequent intensified muscle contractility, mitochondrial dysfunction, and production of oxygen radicals. Case Report: We report a case of a middle-aged black woman with rhabdomyolysis that was caused by intense shivering chills, and rigor from pneumonitis. She had no personal or family history of muscle disorder and was admitted to the hospital after a weeklong history of upper and lower respiratory symptoms that led to the worse shivering and shaking chills she ever had. She was noted to have elevated creatine phosphokinase (CPK) of 200,000 uL (26–192 uL) and creatinine level of 5.52 (0.81–1.2 mg/dL). She was started on intravenous fluid with half-isotonic saline (0.45%) or 77 mmol/L sodium, 75 mmol/L sodium bicarbonate, and hemodialysis with progressive improvement in kidney function that took up to seven weeks to full recovery. Conclusion: Shivering and shaking chills from respiratory infection can cause rhabdomyolysis with severe muscle damage and renal failure in a patient with no known underlying muscular-skeletal disorder condition but has good recovery with fluid management and hemodialysis. Renal function has returned back to normal.

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Section: Discussionmentioning

confidence: 99%