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Journal of Anesthesia

Erschienen in:

28.02.2017 | Guideline

JSA guideline for the management of malignant hyperthermia crisis 2016

verfasst von: Safety Committee of Japanese Society of Anesthesiologists

Erschienen in: Journal of Anesthesia | Ausgabe 2/2017

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Abstract

Malignant hyperthermia (MH) can be fatal if the crisis is not appropriately treated. It is an inherited disease usually triggered by the administration of volatile inhalational anesthetics and/or succinylcholine, a muscle relaxant. In a patient with suspected MH, the mechanism of calcium release from storage in the sarcoplasmic reticulum in the skeletal muscle is abnormally accelerated. Unexplained hypercarbia representing >55 mmHg of end-tidal carbon dioxide, tachycardia, and muscle rigidity (including masseter muscle rigidity) are early signs of the initiation of MH, because the metabolism is accelerated. The body temperature can rise by >0.5 °C/15 min and may reach ≥40 °C. Respiratory and metabolic acidosis, arrhythmia, cola-colored urine, increased levels of serum potassium, and tented T-waves on electrocardiogram are common and can lead to cardiac arrest. MH should be treated by discontinuation of the triggering agents, administration of intravenous dantrolene (initially 1 mg/kg), and reduction of the body temperature. Early diagnosis and sufficient dantrolene with body temperature reduction are essential to relieve the patient’s MH crisis. This guideline in Japanese translation has been posted on the website: http://www.anesth.or.jp/guide/pdf/guideline_akuseikounetsu.pdf.

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Titel: JSA guideline for the management of malignant hyperthermia crisis 2016
verfasst von: Safety Committee of Japanese Society of Anesthesiologists
Publikationsdatum: 28.02.2017
Verlag: Springer Japan
Erschienen in: Journal of Anesthesia / Ausgabe 2/2017
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-016-2305-z

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