Clinical protocol for the management of malignant hyperthermia

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• 作者：A. Kollmann-Camaiora^a ; ^{and_c@hotmail.com} ; E. Alsina^a ; A. Domí ; nguez^a ; B. del Blanco^b ; M.J. Yepes^c ; J.L. Guerrero^d ; A. Garcí ; a^d
• 关键词：Malignant hyperthermia ; Dantrolene sodium ; Ryanodine receptor
• 刊名：Revista Española de Anestesiología y Reanimación (English Edition)
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：64
• 期：1
• 页码：32-40
• 全文大小：961 K
• 卷排序：64

文摘

Malignant hyperthermia is a hypermetabolic syndrome that appears in susceptible patients after exposure to certain anaesthetic drugs (succinylcholine, inhalation anaesthetics). Its incidence in Spain is 1 in 40,000 adults, with a 10% mortality rate. It is induced by an abnormal regulation of the ryanodine receptors, producing a massive release of calcium from the sarcoplasmic reticulum in the striate muscle. Clinical manifestations include: CO2 increase, tachycardia, haemodynamic instability, metabolic and respiratory acidosis, profuse sweating, hyperpyrexia, CPK increase, myoglobinuria, kidney failure, disseminated intravascular coagulation (DIC), and ending in cardiac arrest. Dantrolene sodium is a ryanodine receptor antagonist, and inhibits the release of intracellular calcium. Definitive diagnosis is achieved by the exposure of muscle fibres to caffeine and halothane.Protocols can help guarantee a reliable and secure management when this severe event occurs.