[HSF] Rhabdomyolysis following CABG

[Nasser F. Abou'Seada]

Could you possibly post the CT  / MRI scans ?
NFA
On Jan 30, 2008 1:19 PM, alsadd <alsadd at ksu.edu.sa> wrote:

> Dear Forum Members:
>
>
>
>
>
> While I was out of town one of our surgeons operated a 69 years old man
> for
> a 3 vessel disease. The patient had bilateral carotid stenosis the right
> 70%
> and the left 80% he had no symptoms because of the vascular surgeon
> elected
> to do nothing. At surgery the patient had LIMA to LAD, SVG to Diagonal and
> OM1. After protamine ST segment changes and drop in BP. They re-haprinized
> went back to for a short time elected not to reverse heparin the second
> time
> and put an IABP.
>
> The patient remained stable post op and was extubated the following
> morning.
> IABP removed. The evening of that day became confused and combative ABG
> were
> acceptable had to be re intubated over night. It was noticed that his CPK
> level kept on rising initially to 7000 and later to more than 10000 units.
> He was put on PRISMA for renal failure in spite of this  his K went up and
> was controlled but with difficulty. The following morning he developed
> epidermolysis and blisters of the lower extremities skin no compartment
> was
> found on assessment both the femoral veins and arteries were patent by
> duplex assessment. He was seen by neurology CT scan and MRI were normal.
> Abdominal CT was normal. He was assessed by various services and the
> differential diagnoses were narrowed to rhabdomyolysis. Any thoughts from
> members would be greatly appreciated
>
>
>
>
>
> Ahmed
>
>
>
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