TRAIN-OF-FOUR MONITORING AND THE PERSISTENT PROBLEM OF RESIDUAL NEUROMUSCULAR BLOCKADE

Background: Carnitine palmitoyl transferase 2 (CPT-2) deficiency is the most common inherited disorder of long chain fatty acid mitochondrial transport, and the cause of recurrent rhabdomyolysis in children and adults. Case presentation: Here we present a case of a six-years-old child with severe rhabdomyolysis, where multiorgan failure (renal, hepatic, respiratory, cardiovascular, neurological) occurred and full multiple organ intensive care unit support was needed. A CPT 2 deficiency was established with genetic testing. Conclusions: A suspicion of CPT deficit should always be present, in case of elevated levels of creatinine kinase and rhabdomyolysis, with early rehydration therapypromptlystarted, hemodiafiltration, respiratory and cardiovascular support if needed.