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

The authors report on the course of a fulminant malignant hyperthermia (MH) associated with laminectomy in a 29-year-old man who had been healthy up to that time. Succinylcholine and isoflurane were considered to be the causative triggering agents. Progression could be prevented due to an early suspicion raised by end-expiratory CO2 measurement: treatment was instituted immediately (Dantrolene 2mg/kg body weight, oxygen hyperventilation, external cooling, etc.) Serum creatine kinase increased up to almost 50,000 U/l associated with massive myoglobinuria. Residue-free restitution was achieved within a few days. Decisive for an early detection of MH is the routine performance of end-expiratory CO2 measurement which is definitely superior to temperature control and significantly reduces the time that elapses before treatment is initiated.
Anasthesiol Intensivmed Notfallmed Schmerzther 1991 Dec
PMID:[The early diagnosis of malignant hyperthermia--the place of end-expiratory CO2 monitoring]. 178 8

An eight-year-old boy was scheduled for an orthopaedic operation with a clinically abortive reaction of malignant hyperthermia and a positive platelet test result. Since there has been no validation for this platelet test, we performed a muscle biopsy and the caffeine- halothane-contracture test (CHCT). The young patient was found to be negative (MHN) in CHCT. Furthermore, the valence and the validity of the used platelet test are discussed for diagnostic purposes. With regard to resulting consequences, first of all in respect of possibly false negative results, we suggest to investigate all patients classified by this platelet test with the accepted and established CHCT.
Anasthesiol Intensivmed Notfallmed Schmerzther 1991 Dec
PMID:[Diagnosis of malignant hyperthermia. The platelet test versus the in vitro contracture test]. 178 9

We report on the fulminant crisis of malignant hyperthermia occurring in a 30-year-old female during kidney transplantation. In the past, she had been anaesthetised repeatedly without complications. Anaesthesia was induced with thiopental and vecuronium and continued with isoflurane/N2O/O2. After an initially normal course of anaesthesia, the patient developed symptoms of a fulminant malignant hyperthermia (MH) including excessive increase in end expiratory CO2, hyperkalaemia, tachycardia and hyperpyrexia. The patient was saved by the timely administration of dantrolene. A surgical revision required the next day because of bleeding was done under dantrolene cover and took an uncomplicated course. The patient was extubated 7.5 hours after the second intervention and transferred to a normal ward after 4 days. A subsequently performed in vitro contracture test clearly revealed susceptibility to malignant hyperthermia.
Anasthesiol Intensivmed Notfallmed Schmerzther 1991 Dec
PMID:[Fulminant malignant hyperthermia during the 6th general anesthesia using volatile anesthetics]. 178 10

Malignant hyperthermia syndrome (MHS) is rare, inherited, and triggered by volatile anesthetics and depolarizing muscle relaxants. While potentially fatal, if recognized and treated early recovery is usual. However, the condition is often not recognized until an extreme increase in temperature develops with profound circulatory depression. In this stage the syndrome is irreversible, despite specific treatment with dantrolene. At present, the only reliable diagnostic test for susceptibility to malignant hyperthermia requires sampling of viable muscle for in vitro contracture tests with caffeine and halothane. Until our malignant hyperthermia diagnostic center was opened, such tests could not be performed in Israel. Since then we encountered a 22-year-old man who developed the partial picture of malignant hyperthermia syndrome during anesthesia for inguinal herniorrhaphy. He received dantrolene and recovered. 4 months later in vitro contracture tests with caffeine and halothane performed on biopsied muscle confirmed the diagnosis.
Harefuah 1991 Dec 15
PMID:[In vitro diagnosis of malignant hyperpyrexia syndrome]. 179 53

In vitro pharmacological responses of fresh biopsy specimens of human skeletal muscle were used as indicators of some intrinsic muscle properties. The measured parameters that were utilized for the current study were contractures induced in vitro by caffeine or by caffeine plus halothane. The opportunity to study such specimens arose from clinical testing for diagnosing the genetic predisposition to malignant hyperthermia, a potentially fatal complication of anaesthesia. The current analysis covers data from over 1,000 subjects, most of whom were clinical suspects and relatives of these. Responsiveness of the muscle specimens varied over two orders of magnitude. The frequency distribution curves suggest that the variation does not represent a continuum but that there are three or more clusters of functional variants. Muscle specimens from males were on average more responsive to caffeine than were those from females. Correlations within father-son and brother-brother pairs indicated complete heritability of responsiveness; this might have been expected but the surprise was a lack of correlation within mother-daughter pairs. There was an intermediate correlation in father-daughter pairs. The sex difference in heritability could be due to gender-related modifying genes or due to secondary modification of the muscle response in females by sex-related, perhaps hormonal factors. Among the effects of age appeared to be poor development in early childhood of the potentiation of the caffeine contracture by halothane.
Pharmacogenetics 1991 Dec
PMID:Pharmacogenetics of caffeine and caffeine-halothane contractures in biopsies of human skeletal muscle. 184 76

An overview of several perioperative complications and their management strategies is presented. Operative hypothermia, malignant hyperthermia, bronchospasm, and side effects of spinal opioid agents are discussed. Ramifications of these complications may extend well beyond the operative period and influence patient outcome. Therefore, it is necessary that the surgeon have a fundamental understanding of the pathophysiology and modalities of treatment in the context of anesthesia and surgery.
Surg Clin North Am 1991 Dec
PMID:Perioperative complications of anesthesia. 194 66

Postoperative patients have difficulty maintaining thermal balance for several reasons. Normal thermoregulation is suppressed by anesthesia, neuromuscular blocking agents, and other drugs, and cool environmental conditions and exposure contribute to heat loss. Specific patient groups at high risk for hypothermia include infants, the elderly, and the neurologically impaired. Temperature drift, afterfall, shivering, malignant hyperthermia, and fever are among the temperature-related conditions requiring vigilant assessment and nursing action during the postoperative period.
Crit Care Nurs Clin North Am 1990 Dec
PMID:Temperature problems in the postoperative period. 209 63

In this review, constituting the 1990 International Lecture of the Biophysical Society, research is described in two areas in which molecular genetic techniques were used to dissect problems related to sarcoplasmic reticulum proteins: the use of site-directed mutagenesis to gain insight into the mechanism of Ca2+ transport by the Ca2(+)-ATPase; and the use of cloning and genetic linkage analysis to identify the Ca2+ release channel (RYR1) gene as a candidate gene for the predisposition to malignant hyperthermia, a neuromuscular disease of humans and domestic animals.
Biophys J 1990 Dec
PMID:Molecular tools to elucidate problems in excitation-contraction coupling. 217 55

The time course of changes in brain electrical activity during halothane anesthesia was examined in 12 malignant hyperthermia-susceptible (MHS) and 14 normal (nMHS) swine. Power densities in selected frequency bands were calculated from the electroen-cephalogram (EEG). EEG and systemic variables were determined over a period of 60 min after starting halothane (1% inspired). Malignant hyperthermia (MH) was triggered in all susceptible pigs. Initial changes in the EEG during development of MH consisted of a decrease in total power and a shift to lower frequencies (delta-theta activity) in all animals. These EEG alterations were noted when there was an increase in heart rate, but other systemic variables were still normal. EEG changes in all MHS animals started at an arterial oxygen tension (PaO2) greater than 90 mmHg and an arterial carbon dioxide tension (PaCO2) less than 50 mmHg. In 5 MHS animals EEG became isoelectric at a PaO2 of 61-82 mmHg and a PaCO2 of 53-68 mmHg. Mean arterial blood pressure at this time was 54-66 mmHg. To determine the effects of hypoxia on the EEG in 7 nMHS animals, oxygen was decreased over a period of 45-60 min to 7% inspired. In 7 other nMHS animals, hypercarbia was produced by admixture of carbon dioxide to the fresh gas supply to achieve incremental increases of PaCO2 to 110-120 mmHg. Significant EEG changes during hypoxia comparable to those seen at the onset of MH were noted at a PaO2 below 40 mmHg and during hypercarbia at a PaCO2 greater than 68 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)
Anesthesiology 1990 Dec
PMID:Alterations in brain electrical activity may indicate the onset of malignant hyperthermia in swine. 224

The adult respiratory distress syndrome developing within 24 hours in a patient who underwent suction lipectomy for body contouring under general anaesthesia is reported. During surgery, in which a total of 1.3 l of suction matter was removed, the patient became haemodynamically unstable and mildly hyperthermic. Subsequently, clinical signs and symptoms of the fat embolism syndrome developed. Aggressive haemodynamic and respiratory support over an 8-day period resulted in patient survival. Malignant hyperthermia was excluded as cause for the clinical presentation on muscle biopsy and in vitro caffeine contracture studies. Although usually complication-free, suction lipectomy may be associated with life-threatening incidents. Even suction volumes as low as 1.3 l have potential hazards, therefore the procedure merits regular postoperative observation and re-assessment.
S Afr Med J 1990 Dec 01
PMID:Fulminant adult respiratory distress syndrome after suction lipectomy. A case report. 225 20


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