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