title: Clinical protocol for the management of malignant hyperthermia.
abstract: Malignant hyperthermia is a hypermetabolic syndrome that appears in susceptible patients after exposure to certain anaesthetic drugs (succinylcholine, inhalation anaesthetics). Its incidence in Spain is 1 in 40,000 adults, with a 10% mortality rate. It is induced by an abnormal regulation of the ryanodine receptors, producing a massive release of calcium from the sarcoplasmic reticulum in the striate muscle. Clinical manifestations include: CO2increase, tachycardia, haemodynamic instability, metabolic and respiratory acidosis, profuse sweating, hyperpyrexia, CPK increase, myoglobinuria, kidney failure, disseminated intravascular coagulation (DIC), and ending in cardiac arrest. Dantrolene sodium is a ryanodine receptor antagonist, and inhibits the release of intracellular calcium. Definitive diagnosis is achieved by the exposure of muscle fibres to caffeine and halothane. Protocols can help guarantee a reliable and secure management when this severe event occurs.
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España. Electronic address: and_c@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Kollmann-Camaiora
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Alsina
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Domínguez
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Clínico Universitario San Carlos, Madrid, España.
authors.forename: B
authors.initials: B
authors.lastname: Del Blanco
authors.affiliation: Departamento de Anestesiología y Reanimación, Clínica Universidad de Navarra, Pamplona, Navarra, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Yepes
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Virgen de la Victoria, Málaga, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Guerrero
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Virgen de la Victoria, Málaga, España.
authors.forename: A
authors.initials: A
authors.lastname: García
mesh_terms: D000293:Adolescent; D000328:Adult; D002110:Caffeine / Q000494:pharmacology; D020013:Calcium Signaling / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods; D003620:Dantrolene / Q000494:pharmacology / Q000627:therapeutic use; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D006221:Halothane / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008305:Malignant Hyperthermia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D009119:Muscle Contraction / Q000187:drug effects; D018485:Muscle Fibers, Skeletal / Q000187:drug effects; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis; D019837:Ryanodine Receptor Calcium Release Channel / Q000187:drug effects / Q000502:physiology; D020230:Serotonin Syndrome / Q000175:diagnosis
chemical_list: D019837:Ryanodine Receptor Calcium Release Channel; D002110:Caffeine; D003620:Dantrolene; D006221:Halothane
keywords: Dantrolene sodium; Dantroleno sódico; Hipertermia maligna; Malignant hyperthermia; Receptor de rianodina; Ryanodine receptor