Compartment syndrome after gynecologic laparoscopy: systematic review of the literature and establishment of normal values for postoperative serum creatine kinase and myoglobin levels

Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is important to diagnose rhabdomyolysis as soon as possible and start the treatment according to severity, as it is a state that significantly increases the mortality of the patients. The current gold standard of rhabdomyolysis diagnosis is the creatine kinase plasma concentration test, but it can be also diagnosed with imaging techniques, such as ultrasound (US). This review aims to gather previously published information regarding sonographic appearance of rhabdomyolysis. We searched through PubMed and ScienceDirect databases for studies using designed queries. After the selection process we were left with 13 studies containing a description of US appearance of rhabdomyolysis confirmed with a CK plasma level test. Findings described in the majority of the cases were muscle thickening, ground glass opacity, traits of edema and anechoic areas. Other than these, there were several less often reported findings. As a conclusion, rhabdomyolysis seems to have its own US appearance, but for now it cannot be precisely specified and needs further research for clarification.

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Postoperative serum creatine kinase (CK) levels in patients treated with lumbar PSO

Brain and Spine ◽

10.1016/j.bas.2021.100420 ◽

2021 ◽

Vol 1 ◽

pp. 100420

Author(s):

A. Abramovic ◽

S. Lener ◽

P.-P. Girod ◽

S. Hartmann ◽

C. Thomé

Keyword(s):

Creatine Kinase ◽

Serum Creatine Kinase ◽

Postoperative Serum

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Factors Associated With Poor Outcomes in Acute Forearm Compartment Syndrome

Hand ◽

10.1177/1558944719884662 ◽

2019 ◽

pp. 155894471988466 ◽

Cited By ~ 1

Author(s):

Dafang Zhang ◽

Stein J. Janssen ◽

Matthew Tarabochia ◽

Arvind von Keudell ◽

Brandon E. Earp ◽

...

Keyword(s):

Creatine Kinase ◽

Logistic Regression ◽

Compartment Syndrome ◽

Serum Creatine Kinase ◽

Regression Analyses ◽

Factors Associated ◽

Poor Outcome ◽

Multivariable Logistic Regression ◽

Forearm Compartment Syndrome ◽

Poor Outcomes

Background: There is limited literature on risk stratification of patients with acute forearm compartment syndrome. The primary objective of this study was to identify factors associated with poor outcomes in patients with acute forearm compartment syndrome. Methods: We retrospectively identified 130 patients with acute compartment syndrome of 130 forearms treated with fasciotomies from January 2000 to June 2015 at 2 Level 1 trauma centers. Poor outcome was defined as a composite variable, including: (1) death; (2) limb amputation; (3) persistent neurological deficit; and (4) contracture. Patient- and treatment-related variables were collected. Bivariate analyses were used to screen for variables associated with poor outcome, and explanatory variables with a value of P < .05 were included in our multivariable logistic regression analyses. Results: Of the 130 patients, 43 (33%) with acute forearm compartment syndrome had poor outcomes, including 5 deaths, 5 limb amputations, 21 persistent neurological deficits, and 31 contractures. Multivariable logistic regression analyses showed that elevated serum creatine kinase at presentation ( P < .05) was associated with poor outcomes in patients with acute forearm compartment syndrome. Receiver operating characteristic curve analysis showed that a serum creatine kinase cutoff of 300 U/L yields 92% sensitivity and a serum creatine kinase cutoff of 10 000 U/L yields 95% specificity for poor outcomes in acute forearm compartment syndrome. Conclusions: Elevated creatine kinase levels above 300 U/L are a useful screening test for the highest risk patients with acute forearm compartment syndrome. Levels above 10 000 U/L may play a role in informed consent and counseling regarding expectations.

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