can happen in adults/peds who received prop at 4-5 mg/kg/hr for 48 hours
Risk factors:
- young age
- severe respiratory or CNS dysfunction
- iatrogenic catecholamine
- steroids
- insufficient carbs
Labs
- Rhabdo --> CK, urine myoglobin
- Renal failure (from rhabdo) --> oligo/anuria --> elevated Cr/K
- Lipemia --> high serum triglycerides, hepatomegaly, elevated AST/ALT
- metabolic acidosis
- enlarged fatty liver
Manifestations
- acute refractory bradycardia --> asystole
Treatment
- supportive
- hemodialysis