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Malignant Hyperthermia

Malignant Hyperthermia. Presented by Joshua Ward. What is MH?. Rare, life-threatening condition triggered by drugs used for general anesthesia Causes uncontrolled increase in skeletal muscle metabolism Susceptibility is inherited as autosomal dominant disorder. Signs of MH. Early signs

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Malignant Hyperthermia

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  1. Malignant Hyperthermia Presented by Joshua Ward

  2. What is MH? • Rare, life-threatening condition triggered by drugs used for general anesthesia • Causes uncontrolled increase in skeletal muscle metabolism • Susceptibility is inherited as autosomal dominant disorder

  3. Signs of MH • Early signs • Hypercapnia • Tachycardia • Masseter muscle rigidity • Late signs • ECG changes, arrhythmias • Rhabdomyolysis • Hyperthermia

  4. Acute management • Intubation (if not already intubated) • Oxygenation and ventilation • ↑ inspired O2 to 100%; increase ventilation rate/tidal volume • Discontinue offending agents • Administer dantrolene • Only known antidote • Binds ryanodine receptors and blocks sarcoplasmic reticulum Ca release • Monitor for hyperkalemia and check labs • Initiate supportive care

  5. Ongoing Care • Place in ICU • Continue maintenance dosing of dantrolene • 48 hrs after last observed sign • Counsel patient • Avoid anesthesia with triggering agents • Avoid excessive heat and humidity • Inform family members

  6. Thank You Resources • UpToDate, Malignant Hyperthermia: Clinical diagnosis and management of acute crisis, http://www.uptodate.com/contents/malignant-hyperthermia-clinical-diagnosis-and-management-of-acute-crisis?source=search_result&search=malignant+hyperthermia&selectedTitle=1~72 • Rosenberg H, Davis M, James D, Pollock N, Stowell K. Malignant hyperthermia. Orphanet J Rare Dis. 2007;2:21.

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