Anesthesia Emergency: Malignant Hyperthermia
Max Feinstein・13 minutes read
Malignant hyperthermia is a rare, life-threatening condition due to dysregulated calcium triggered by specific drugs, more prevalent in children, and can lead to serious complications and death. Anesthesiologists need to promptly identify and treat it with dantrolene and supportive measures to improve survival rates, despite challenges in diagnosis and susceptibility testing.
Insights
- Malignant hyperthermia is a rare, life-threatening condition triggered by specific drugs, causing uncontrolled calcium release in muscles and potentially leading to severe complications and death.
- Anesthesiologists need to be vigilant in recognizing and promptly treating malignant hyperthermia, as its prevalence is higher in children than in adults, emphasizing the importance of preparedness and swift intervention to improve patient outcomes.
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Recent questions
What is malignant hyperthermia?
Malignant hyperthermia is a rare, life-threatening condition characterized by a hyper-metabolic state triggered by certain drugs like succinylcholine and anesthetic gases. It leads to uncontrolled calcium release in muscles, causing complications like hyperkalemia, disseminated intravascular coagulation, and organ failure.
How prevalent is malignant hyperthermia?
Malignant hyperthermia is more prevalent in children, with a frequency of 1 in 15,000 compared to adults at 1 in 40,000. A study found 84 reported events of malignant hyperthermia over five years, resulting in 1.6 deaths annually in the US.
What are the signs of malignant hyperthermia?
Signs of malignant hyperthermia include muscle rigidity, hypercarbia, tachycardia, and increased temperature. Prompt identification of these symptoms is crucial for timely treatment and better survival rates.
How is malignant hyperthermia treated?
Treatment for malignant hyperthermia involves discontinuing triggering agents, administering dantrolene, monitoring vital signs, and using cold IV fluids and bicarbonate. Ventilator settings may include 100% FiO2, high flows, and hyperventilation.
How is susceptibility to malignant hyperthermia diagnosed?
Susceptibility to malignant hyperthermia can be diagnosed through invasive tests like the caffeine halothane contracture test or genetic testing. However, these methods have limitations, and diagnosis can be challenging. Anesthesiologists must be prepared to identify and treat malignant hyperthermia promptly to improve patient outcomes.
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Summary
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Managing Malignant Hyperthermia: An Overview
- Anesthesia resident at Mount Sinai Hospital in New York City discussing malignant hyperthermia, a rare but life-threatening condition.
- Malignant hyperthermia is a hyper-metabolic state due to dysregulated calcium, triggered by certain drugs like succinylcholine and anesthetic gases.
- Prevalence of malignant hyperthermia is higher in children (1 in 15,000) compared to adults (1 in 40,000).
- Study found 84 reported events of malignant hyperthermia over five years, with 1.6 deaths annually in the US.
- Anesthesiologists must be prepared to identify and treat malignant hyperthermia promptly for better survival rates.
- Malignant hyperthermia causes uncontrolled calcium release in muscles, leading to complications like hyperkalemia, disseminated intravascular coagulation, and organ failure.
- Diagnosis of malignant hyperthermia can be challenging, but signs include muscle rigidity, hypercarbia, tachycardia, and increased temperature.
- Treatment involves discontinuing triggering agents, administering dantrolene, monitoring vital signs, and using cold IV fluids and bicarbonate.
- Ventilator settings for suspected malignant hyperthermia include 100% FiO2, high flows, and hyperventilation.
- Susceptibility to malignant hyperthermia can be diagnosed through invasive tests like the caffeine halothane contracture test or genetic testing, but these methods have limitations.
