Recrudescence after Survival of an Initial Episode of Malignant Hyperthermia

Mathieu, Alix; Bogosian, Armen J.; Ryan, John F.; Crone, Robert K.; Crockr, Dean

doi:10.1097/00000542-197911000-00016

Cited by 44 publications

(5 citation statements)

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“…Recrudescence was associated with a temperature increase (tables 3 and 5) but not the other signs of MH (muscle rigidity, muscle breakdown, respiratory acidosis, and cardiac involvement) from the MH CGS. 16 Case reports had previously suggested persistent rigidity, 10 hyperkalemia and oliguria, 10 shivering, 14 and persistent tachycardia 11,13 as clinical signs that may predict recrudescence of MH. Elevated temperature may make it easier to trigger an MH episode.…”

Section: Recrudescence Of Mhmentioning

confidence: 99%

Analysis of the Clinical Variables Associated with Recrudescence after Malignant Hyperthermia Reactions

Burkman¹,

Posner²,

Domino

2007

Anesthesiology

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Section: Recrudescence Of Mhmentioning

confidence: 99%

Analysis of the Clinical Variables Associated with Recrudescence after Malignant Hyperthermia Reactions

Burkman¹,

Posner²,

Domino

2007

Anesthesiology

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“…His temperature, but not his heart rate, quickly returned to normal following the dantrolene. Mathieu et al report two cases that developed fatal recrudescence 30 h after an anaesthetic using suxamethonium and halothane, both of which were associated with marked muscle rigidity which they suggest to be an ominous sign [7]. Muscle rigidity was not a feature of our patient at any time which may have explained his rapid response to treatment and subsequent good recovery.…”

Section: Introductionmentioning

confidence: 69%

Malignant hyperthermia during prolonged surgery for tumour resection

Morrison

Serpell

1998

Eur J Anaesthesiol

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The onset of malignant hyperthermia in a patient during a prolonged anaesthetic for tumour resection is described. The onset was delayed with a gradual rise in heart rate and PETCO2 before becoming fulminant; muscle rigidity was not a feature. Other aspects of the patient's condition confused the presentation, delayed the diagnosis and may have been involved in precipitating the event. However, it responded rapidly to treatment and surgery was continued. A possible recrudescence occurred 18 h later. Malignant hyperthermia should be considered early in cases of unexplained tachycardia or rising PETCO2.

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“…The other criterion for discontinuation of dantrolene is for the core body temperature to be decreasing: this assumes that active body cooling has been implemented as part of the MH treatment protocol. 9 It should be noted that the hypermetabolic features of MH may recur within the first 24 h after initial resolution, 28 and will require further treatment with dantrolene. Such recrudescence was reported to occur in 20% of North American MH cases, 29 but 10e15% is perhaps a more realistic estimate.…”

Section: Dosing Schedule For Dantrolenementioning

confidence: 99%

Availability of dantrolene for the management of malignant hyperthermia crises: European Malignant Hyperthermia Group guidelines

Glahn

Bendixen

Girard

et al. 2020

British Journal of Anaesthesia

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Faced with a malignant hyperthermia crisis, the immediate access to sufficient dantrolene is essential to achieve the best possible outcome for the patient. However, malignant hyperthermia crises are rare, and there may be administrative pressures to limit the amount of dantrolene stocked or, in some countries, not to stock dantrolene at all. There are no published guidelines to support anaesthetic departments in their effort to ensure availability of sufficient dantrolene for the management of malignant hyperthermia crises. After a literature review that confirmed a lack of clinical trials to inform this guideline, we undertook a formal consensus development process, in which 25 members of the European Malignant Hyperthermia Group participated. The consensus process used a modified web-based Delphi exercise, in which participants rated the appropriateness of statements that covered the dosing regimen for dantrolene in a malignant hyperthermia crisis, the types of facility that should stock dantrolene, and the amount of dantrolene that should be stocked. The resulting guidelines are based on available evidence and the opinions of international malignant hyperthermia experts representing a large group of malignant hyperthermia laboratories from around the world. Key recommendations include: the dosing regimen of dantrolene should be based on actual body weight, dantrolene should be available wherever volatile anaesthetics or succinylcholine are used, and 36 vials of dantrolene should be immediately available with a further 24 vials available within 1 h.

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Recrudescence after Survival of an Initial Episode of Malignant Hyperthermia

Cited by 44 publications

References 0 publications

Analysis of the Clinical Variables Associated with Recrudescence after Malignant Hyperthermia Reactions

Analysis of the Clinical Variables Associated with Recrudescence after Malignant Hyperthermia Reactions

Malignant hyperthermia during prolonged surgery for tumour resection

Availability of dantrolene for the management of malignant hyperthermia crises: European Malignant Hyperthermia Group guidelines

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