Korean J Thorac Cardiovasc Surg.  2014 Apr;47(2):181-184.

Massive Rhabdomyolysis Following Cardiopulmonary Bypass

• Kim YS
• Yoon YH
• Kim JT
• Baek WK

Abstract

Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.

Keyword

Rhabdomyolysis; Malignant hyperthermia; Cardiopulmonary bypass

MeSH Terms

Acidosis
Brain
Brain Injuries
Cardiopulmonary Bypass*
Coma
Consciousness
Creatine Kinase
Fever
Heart Septal Defects, Ventricular
Humans
Hypothermia
Malignant Hyperthermia
Rhabdomyolysis*
Creatine Kinase