Malignant Hyperthermia
Article Sections
Introduction
Malignant hyperthermia is a rare but potentially life-threatening disorder characterized by a hypermetabolic response to volatile anesthetics and depolarizing muscle relaxants. Most cases arise shortly after induction or during maintenance of anesthesia in susceptible individuals. A genetic defect in skeletal muscle receptors causes sustained muscle contraction, which can lead to hypercarbia, metabolic acidosis, rhabdomyolysis, and hyperthermia. Malignant hyperthermia is a clinical diagnosis that requires immediate treatment with dantrolene (a muscle relaxant), along with supportive measures (eg, cooling), to prevent death.
Risk factors
- Genetic predisposition: Autosomal dominant genetic mutation causes abnormal ryanodine receptors (RYR1) in the skeletal muscle () Figure 1
- Anesthetic exposure: This is the main trigger for malignant hyperthermia in susceptible patients. It involves volatile anesthetics (eg, halothane, isoflurane) and depolarizing muscle relaxants
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