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Case Reports in Critical Care
Volume 2017 (2017), Article ID 5764961, 8 pages
https://doi.org/10.1155/2017/5764961
Case Report

The Use of Coupled Plasma Filtration Adsorption in Traumatic Rhabdomyolysis

1Anaesthesia and Intensive Care Unit, General Hospital “Pugliese-Ciaccio”, Viale Pio X, 88100 Catanzaro, Italy
2Bellco, 41037 Mirandola, Italy

Correspondence should be addressed to Mario Pezzi; ti.oohay@izzepoiram

Received 15 September 2016; Revised 30 November 2016; Accepted 19 February 2017; Published 19 March 2017

Academic Editor: Nicolas Nin

Copyright © 2017 Mario Pezzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Severe musculoskeletal injuries induce the release of sarcoplasmic elements such as muscle enzymes, potassium, and myoglobin in the systemic circulation. The circulating myoglobin damages the glomerulus and renal tubules. Conventional haemodialysis is not able to remove myoglobin, due to its high molecular weight (17,8 kilodaltons [kDa]). We treated four traumatic rhabdomyolysis patients with Coupled Plasma Filtration Adsorption (CPFA) in order to remove myoglobin followed by 14 hours of Continuous Veno-Venous Hemofiltration (CVVH). During the treatment, all patients showed clinical improvement with a decrease in muscular (creatine kinase [CK] and myoglobin) and renal (creatinine and potassium) damage indices. One patient, in spite of full renal recovery, died of cerebral haemorrhage on the 26th day of hospital stay.