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MH
1
Malignant Hyperthermia is an acute pharmacogenetic disorder which develops during, or immediately after, general anaesthesia involving the use of volatile agents and/or depolarising muscle-relaxants.
The disorder is thought to be due to a defect in calcium channel regulation in skeletal muscle.
The malignant hyperthermia crisis consists of a hyper-metabolic state caused primarily by continued contraction of skeletal muscle, which leads to massive CO2 production, skeletal muscle rigidity, tachyarrhythmias, unstable haemodynamics, respiratory acidosis, cyanosis, hyperkalaemia, lactic acidosis, fever, and eventually (if untreated) death. MH can present with a few or all of these features.
www.anaesthesia.mh.org.au...
The disorder is thought to be due to a defect in calcium channel regulation in skeletal muscle.
The malignant hyperthermia crisis consists of a hyper-metabolic state caused primarily by continued contraction of skeletal muscle, which leads to massive CO2 production, skeletal muscle rigidity, tachyarrhythmias, unstable haemodynamics, respiratory acidosis, cyanosis, hyperkalaemia, lactic acidosis, fever, and eventually (if untreated) death. MH can present with a few or all of these features.
www.anaesthesia.mh.org.au...
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Dec 23, 2012
Management:
Declare emergency.
Cease triggering agent.
15L/min 100% O2 through circuit.
Remove/change soda lime.
Hyperventilate to normalise pCO2.
Allocate tasks to team members.
Commence dantrolene (2.5mg/kg every 5-10min to effect, max dose 10mg/kg).
Switch to TIVA.
Active cooling to 38 degrees with ICE and cold IV fluids.
Frequent blood gases.
ICU.
Declare emergency.
Cease triggering agent.
15L/min 100% O2 through circuit.
Remove/change soda lime.
Hyperventilate to normalise pCO2.
Allocate tasks to team members.
Commence dantrolene (2.5mg/kg every 5-10min to effect, max dose 10mg/kg).
Switch to TIVA.
Active cooling to 38 degrees with ICE and cold IV fluids.
Frequent blood gases.
ICU.
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Matthew Routley
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Apr 23, 2012
If in US/Canada, report any suspected cases to North American Registry via medical.mhaus.org/
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Aug 10, 2011
In Victoria, Australia, report suspected cases to Royal Melbourne Hospital malignant hyperthemia registry.
Dr Brad Hockey MB BS FANZCA (Muscle biopsy and IVCT)
Phone: +61 3 9342 7540 or through switchboard +61 3 9342 7000
Fax: +61 3 9342 8623
Email: brad.hockey@mh.org.au
Dr Robyn Gillies MB BS FANZCA (genetic testing)
Phone: +61 3 9342 7540 or through switchboard +61 3 9342 7000
Fax: +61 3 9342 8623
Email: robyn.gillies@mh.org.au
www.anaesthesia.mh.org.au...
Dr Brad Hockey MB BS FANZCA (Muscle biopsy and IVCT)
Phone: +61 3 9342 7540 or through switchboard +61 3 9342 7000
Fax: +61 3 9342 8623
Email: brad.hockey@mh.org.au
Dr Robyn Gillies MB BS FANZCA (genetic testing)
Phone: +61 3 9342 7540 or through switchboard +61 3 9342 7000
Fax: +61 3 9342 8623
Email: robyn.gillies@mh.org.au
www.anaesthesia.mh.org.au...
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Apr 23, 2012