Medidas de prevenção da rabdomiólise em militares: uma revisão da literatura

Abstract

INTRODUCTION: Rhabdomyolysis is a syndrome that has its origin caused by the injury of muscle cells, causing the release of intracellular contents in the circulation. In view of the increasing incidence of rhabdomyolysis in the armed forces, it is important to develop new studies aimed at improving preventive measures, as well as the speed of diagnosis, enabling the accelerated recovery of the affected military and reducing the appearance of health complications inherent to the syndrome process. AIM: The present study aimed to list, through a literature review, the preventive measures that are being used in the control of rhabdomyolysis in military personnel. MATERIALS: A narrative review, with a systematic search of the scientific databases US National Library of Medicine (MEDLINE), Science Direct, Cochrane and LILACS in July 2020. The descriptors “rhabdomyolysis”, “prevention & control” and “military personnel” were used, as well as their respective synonyms. In addition to these articles found, studies that had the same theme, indicated by specialists in the subject in question, were included in the database. There was no language filter or time limit for the search. RESULTS: A total of 20 articles were identified after an electronic database search and 25 papers were included manually. After screening citations, 24 did not meet the inclusion criteria and were excluded. 21 studies met the inclusion criteria for the review. CONCLUSIONS: The fact that rhabdomyolysis is a syndrome caused by several factors ends up hindering its prevention, considering that each person's organism behaves and reacts differently. The main preventive measures listed by this review were: 1) Avoid exposure to high temperatures and maintaining regular hydration; 2) Supervision and coordination of the intensity, duration and type of physical activities by a trained professional, especially in military organizations where individuals have their first contact with military activity and in operational courses, elaboration of a training program that allows the gain fitness gradually; 3) The use of dietary supplements should be done under the guidance of a professional in the field of nutrition, an orientation program and awareness of individuals about the risks of rhabdomyolysis inherent in the use of toxic substances such as alcohol, drugs, medications, among others 4) Use of a nutrition professional to guide adequate nutrient intake 5) Observation of urine color (the darker, the greater the chance of developing rhabdomyolysis), routine blood and urine tests to monitor levels of creatine kinase (CK), myoglobin, sodium and potassium, especially during periods of intense physical activity. Prevention is largely achieved by avoiding risk factors, in this context, increases the importance of lectures and guidance in military organizations aimed at raising the awareness of all military personnel on the subject in question.