Which treatment can help to alkalize urine in cases of traumatic rhabdomyolysis?

The treatment that helps to alkalize urine in cases of traumatic rhabdomyolysis is IV sodium bicarbonate. In rhabdomyolysis, there is a release of myoglobin and other intracellular contents into the circulation, which can lead to acute kidney injury due to their nephrotoxic effects. One of the strategies to mitigate these effects is to promote the excretion of myoglobin, which is more soluble in alkaline urine.

IV sodium bicarbonate increases the pH of the urine, helping to create a more alkaline environment. This alkalinization assists in preventing precipitation and formation of myoglobin casts in the renal tubules, thus reducing the risk of acute tubular necrosis. In addition to alkalinizing the urine, administering sodium bicarbonate can help improve the overall acid-base balance in patients who may develop metabolic acidosis due to severe muscle injury.

Other options do not effectively address the need to alkalize urine in this context. While potassium supplements and topical magnesium cream may have their roles in different clinical situations, they do not confer the necessary alkalinizing effect. Oral calcium tablets also do not contribute to urine alkalization and can potentially cause complications, particularly in a patient with compromised kidney function as seen in rhabdomy