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Query: UMLS:C0024591 (malignant hyperthermia)
 2,353 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of malignant hyperthermia in a Black boy is presented. He developed this condition during repair of a cleft palate, with halothane as the triggering agent. The importance of the high incidence of malignant hyperthermia in patients with certain musculoskeletal abnormalities is stressed. Despite a cool and well air-conditioned theatre, the patient's temperature was 41 degree C when the condition was suspected. At that stage general muscle rigidity was present. The patient was successfully treated with procainamide, sodium bicarbonate and hydrocortisone; surface cooling (with ice packs) was instituted and the stomach was washed out with ice-cold Ringer's solution. Over a period of 14 days serum creatine phosphokinase values decreased from 630 IU (on the day of the incident) to 12 IU. A muscle biopsy showed variation in muscle fibre size. Electron microscopical studies showed myofibrillar disruption and folding of the basement membrane. A modified version of Denborough's technique was used for the in vitro exposure of muscle strips to halothane and suxamethonium. Isometric contraction was measured and recorded. A severe contraction followed the exposure of muscle strips to halothane, which confirmed the diagnosis.
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PMID:[Malignant hyperthermia in a black child. A case report]. 69 25

A possible means of rapid cooling in the emergency treatment of malignant hyperpyrexia, peritoneal dialysis using a cold dialysate, is described. Experimental observations in a young man on a regular peritoneal dialysis regime showed that significant heat extraction can be obtained when either a cool (20 degrees C) or cold (9 degrees C) dialysis fluid is used. The maximum heat exchange observed was 17.5 kJ/min when 2 litre of cold dialysis was instilled for a mean time of 10 min. This rate of heat exchange is within the 10--40 kJ/min range of excess heat production that occurs in malignant hyperpyrexia. Since peritoneal dialysis is, technically, a very quick and simple procedure, it is suggested that it might play a very useful role in the emergency treatment of malignant hyperpyrexia. The dialysis treatment would also correct some of the biochemical disturbances that occur in this condition.
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PMID:A possible means of rapid cooling in the emergency treatment of malignant hyperpyrexia. 127 20

A moderate malignant hyperthermia developed in a Labrador Retriever anaesthetized with isoflurane for a femoral shaft fracture repair. Signs of malignant hyperthermia included progressive increases in PETCO2 and rectal temperature up to 39.8 degrees C, tachycardia, cyanosis, and elevated serum levels of potassium, inorganic phosphorus, AST, CK and alkaline phosphatase. Treatment initiated in the early recovery period consisted of hyperventilation with 100% oxygen, stomach lavage with iced water, body surface cooling, and intravenous administration of cold isotonic saline solution. Cooling was continued until the rectal temperature had dropped to 37.3 degrees C. After treatment the dog recovered uneventfully. Clinical signs, pathophysiology, therapy, prevention of malignant hyperthermia and its association with other disorders are discussed.
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PMID:[Malignant hyperthermia as a complication of anesthesia in the dog]. 144 May 99

A 5-year-old girl susceptible to malignant hyperthermia underwent total repair of tetralogy of Fallot. The initial operation was canceled because of abrupt hyperthermia and metabolic acidosis of unknown cause. Dantrolene was given orally as preoperative treatment and administered intermittently during surgery. Postoperative hyperthermic crisis was successfully treated with intravenous dantrolene combined with surface cooling, gastric tube irrigation with cold saline, and alcohol vaporization.
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PMID:Correction of tetralogy of Fallot accompanied by malignant hyperthermia. Case report. 193 19

Signs of malignant hyperthermia, including progressive increases in PaCO2, skin temperature and heart rate, and elevated serum levels of potassium, inorganic phosphate, and creatine kinase, were identified in a halothane-anesthetized horse. Treatment was discontinuing halothane administration, applying ice and cold fluids, and hyperventilating with 100% oxygen. After an initial recovery, bilateral hindlimb myopathy and pigmenturia developed. The myopathy resolved after treatment with oral dantrolene, IV fluids, and hydrocortisone. Results of caffeine-halothane challenge, using semimembranosus muscle collected 2 weeks after the episode, were considered within normal limits for horses. The intraoperative abnormalities were evidently predictive of postanesthetic myopathy but the cause in this horse remained unclear.
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PMID:Postanesthetic equine myopathy suggestive of malignant hyperthermia. A case report. 260 79

Clinical uses of calcium channel blockers are expanding. In addition to the established uses in patients with arrhythmias, angina pectoris or hypertension, newer and to some extent investigational uses indicate widespread application. For instance, their use has been reported in hypertrophic cardiomyopathy and cold cardioplegia, as well as in pulmonary hypertension, antiplatelet therapy, asthma, achalasia and oesophageal spasm, increased intraocular pressure and in cerebral vasospasm. Their use in obstetrical practice has been proposed. Thus, the presentation of a patient who is treated with calcium channel blockers and who requires anaesthesia will become more common. Calcium channel blockers may, under certain circumstances, potentiate haemodynamic and MAC depressive effects of inhalation agents. There is also evidence that the effects of neuromuscular blocking agents may be potentiated. The anaesthetist should be aware that the potential for interactions exists with digoxin, propranolol, quinidine, theophylline or dantrolene. Of interest and some significance are the anaesthetic implications of pathophysiological alterations that can be induced by calcium channel blockers, by affecting lower oesophageal tone, intracranial hypertension, bronchomotor tone (asthma), muscular dystrophy, neuromuscular function, hypoxic pulmonary vasoconstriction, malignant hyperthermia, inhibition of platelet aggregation and hyperkalemia. Despite these significant potential anaesthetic implications and because, at this time, in some instances withdrawal has clearly demonstrated increase in the signs of myocardial ischaemia, it would not seem necessary to recommend preoperative discontinuation of calcium channel blocker medication in patients presenting for anaesthesia. It is, however, appropriate that there is a high index of awareness of potential problems, unless there is some modification in inhalation anaesthetic concentrations and neuromuscular blocker dosage. Monitoring of cardiovascular and neuromuscular functions is essential. Calcium channel blockers would appear to be currently the drugs of choice for angina pectoris, arrhythmias or hypertension in patients with associated chronic obstructive pulmonary disease.
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PMID:Anaesthetic implications of calcium channel blockers. 286 80

The influence of acclimation to a cold (10 degrees C) or warm (35 degrees C) environment on the functional characteristics of skeletal muscle mitochondria has been investigated in young pigs on a high (H) or low (L) energy intake. Living at 10 degrees C increased the amount of mitochondrial protein and the concentration of cytochrome. Ca2+-stimulated succinate oxidation by mitochondria from the 35H group was tightly coupled and similar to that in pigs living under normal husbandry conditions. Mitochondria from the three other groups were readily uncoupled and thus resembled those from pigs susceptible to malignant hyperthermia. Arrhenius plots of State 3 Ca2+-stimulated succinate oxidation showed that energy intake altered the transition temperature suggesting possible differences in the structure of the mitochondrial membrane.
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PMID:Influence of environmental temperature and energy intake on porcine skeletal muscle mitochondria. 405 86

The anaesthetic management of cardiopulmonary bypass (CPB) for a patient with biopsy-proven malignant hyperthermia is reported. Specific changes in the technique used, such as venting the oxygenator before use, monitoring mixed venous PO2 and PCO2, as well as the safety of cold hyperkalaemic cardioplegia are described. Controversial aspects of malignant hyperthermia management such as the safety of calcium and catechol inotropes are discussed in relationship to the successful use of cardio-pulmonary bypass in our patient. We chose to treat left ventricular dysfunction by aggressive vasodilator (nitroglycerine) therapy. We detected no myocardial or respiratory depression secondary to dantrolene therapy either before or after operation.
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PMID:Management of a malignant hyperthermia patient during cardiopulmonary bypass. 679 80

Malignant hyperthermia developed in a 4-year-old Thoroughbred horse following 3 hours and 15 minutes of halothane anesthesia, with supplementary succinylcholine. Clinical signs included fever, sweating, hyperventilation, tachycardia, and decreased blood pressure followed by a rapid increase in blood pressure. Biochemical aberrations included hypocalcemia, hyperkalemia, hyperphosphatemia, myoglobinuria, and high creatine phosphokinase and ornithine carbamyl transferase activities. Treatment consisted initially of surface cooling with cold water, alcohol and ice, IV administration of cooled balanced electrolyte solutions and sodium bicarbonate, and removal from the anesthetic and rebreathing circuit. Oxygen was given by endotracheal insufflation. The rectum was then packed with ice, the horse was moved to a recovery raft and pool, and his body was packed in ice. Xylazine and dantrolene were given during recovery from anesthesia. Following recovery, treatment consisted of administration of balanced electrolyte solutions, calcium borogluconate, potassium penicillin, meperidine, and additional dantrolene. Muscle biopsy demonstrated exaggerated contracture responses to halothane and caffeine, confirming a diagnosis of malignant hyperthermia. The horse was returned to training following a routine postsurgical convalescent period.
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PMID:Malignant hyperthermia in a halothane-anesthetized horse. 734 3

Early clinical recognition, confirmed by blood gases analysis has permitted successfull management of a case of severe malignant hyperthermia. The authors stress the crucial importance for the theatres area to be fitted up with a huge crushed ice making device and with a large supply of cold saline solution. Due to the lack of easy and reliable preoperative screening test it is mandatory to put high risk patients on Dantrolene therapy when elective surgery is planned.
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PMID:Uneventful recovery in a case of severe malignant hyperthermia. 746 39


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