[Malignant hyperthermia and appendicular sepsis. Can they be differentiated during surgical procedure?].
OBJECTIVE
To assess the possibility to differentiate clinically intraoperative malignant hyperthermia (MH) and sepsis.


METHODS
Comparative retrospective study of clinical cases.


METHODS
Sixteen patients operated on for acute appendicitis and developing clinical signs of MH confirmed or not by in vitro caffeine halothane contracture tests (IVCT).


METHODS
To isolate the patients' characteristics with regard to the diagnosis of sepsis and MH crisis. To compare both groups of clinical features with results of IVCT.


RESULTS
The diagnosis of MH sensitivity has been excluded in ten hyperthermic patients and confirmed in four others with IVCT. No correlation was existing between the importance of perioperative sepsis, MH features and IVTC results.


CONCLUSIONS
This study confirmed the difficulty to differentiate clinically MH and sepsis during surgery. Considering the severe outcome of MH crisis, it is recommended to start the specific therapy even in case of appendicular sepsis.
Strecker
G
G
Département d'anesthésie-réanimation chirurgicale I, hôpital R-Salengro, Lille, France.
Adnet
P
P
Forget
A P
AP
Krivosic-Horber
R
R
D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000150:complications*; D002648:Child; D003620:Dantrolene / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome
D009125:Muscle Relaxants, Central; D003620:Dantrolene