Updated guide for the management of malignant hyperthermia

Updated guide for the management of malignant hyperthermia

This continuing professional development module aims to prepare anesthesiologists for the timely recognition and management of a malignant hyperthermia (MH) reaction, which is crucial for averting its life-threatening complications and ultimately for the patient’s survival.

Malignant hyperthermia is a genetic disorder of skeletal muscle cells affecting myoplasmic calcium homeostasis. It can present with nonspecific signs of a hypermetabolic reaction, which can be fatal if treatment, including administration of dantrolene sodium, is not implemented promptly. Rapid evaluation and rejection of alternative diagnoses can lead to a prompt diagnosis and treatment and therefore will significantly reduce the complications, including renal failure, cardiac dysfunction, disseminated intravascular coagulation, and death. After the reaction, patients should be observed for a minimum of 24 hr because of the possibility of recrudescence. As it is a genetic condition, survivors and their family members should be referred to a specialized MH centre for further testing and counselling.

Objectives of this Continuing Professional Development module:

After reading this module, the reader should be able to:

  1. Demonstrate an understanding of the etiology, pathophysiology, and genetics of malignant hyperthermia.
  2. Define the clinical features of malignant hyperthermia to make a prompt diagnosis.
  3. Describe the steps in the treatment of malignant hyperthermia.
  4. Calculate the recommended required doses of dantrolene for acute as well as post-crisis management of malignant hyperthermia.
  5. Set up the referral of the patient and family members to a malignant hyperthermia specialized centre.

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