[Malignant hyperthermia: new developments in diagnosis and clinical management].
OBJECTIVE
To analyse the current knowledge concerning anaesthetic malignant hyperthermia.


METHODS
References were obtained from computerized bibliographic research (Medline), recent review articles, the library of the service and personal files.


RESULTS
Knowledge to possess, about the diagnosis and treatment of the acute hyperthermia crises and about "safe-anaesthesia" for malignant hyperthermia susceptible patients, are explained. The pathophysiology chapter give information about the calcium's transport and the defect existing in MH. Molecular genetics of MH find linkage to the region encoding the RyR1. The profile of hyperthermia episodes has changed over time due to the endtidal carbon dioxide-monitoring. Clinical aspects of MH are exposed. The treatment of the acute hyperthermia crises consist mainly to stop all triggering agents instantly and infuse dantrolene sodium. The gold standard for the diagnosis of malignant hyperthermia susceptibility relies on the in vitro contracture test (halothane and caffeine). Associated to genetic studies, it could lead to an non-invasive screening of the MH susceptibility. A protocol for "safe-anaesthesia" is proposed. Some syndromes with features similar to those of MH should be known (central core disease and exertionnal rhabdomyolysis).
Dépret
T
T
Département d'anesthésie-réanimation chirurgicale I, hôpital R. Salengro, boulevard E. Laine, CHRU, 59037 Lille, France.
Krivosic-Horber
R
R
D000758:Anesthesia / Q000009:adverse effects; D006801:Humans; D008305:Malignant Hyperthermia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*