Successful early application of extracorporeal membrane oxygenation to support cardiopulmonary resuscitation for a patient suffering from severe malignant hyperthermia and cardiac arrest: a case report

Abstract

Malignant hyperthermia (MH) may lead to metabolic crisis of skeletal muscle in susceptible individuals following exposure to triggering agents such as volatile anesthetics or depolarizing muscle relaxants. MH is a rare and a potentially lethal disease, which can lead to cardiac arrest. We report a case of severe MH, in which the rapidly evolving signs of hypermetabolism eventually resulted in cardiac arrest. Despite conventional treatments following cardiopulmonary resuscitation, the patient's vital signs did not improve. Therefore, we applied extracorporeal membrane oxygenation for providing hemodynamic support.

Combination of extracorporeal membrane oxygenation and inline hemofiltration for the acute hyperkalemic cardiac arrest in a patient with Duchenne muscular dystrophy following orthopedic surgery -a case report-

“…Cardiac arrest could be refractory to CPR and prolonged in acute hyperkalemic cardiac arrest with rhabdomyolysis in patients with myopathy because of sustained hyperkalemia [10]. Previous reports showed that cardiopulmonary bypass and ECMO could be therapeutic options for cardiopulmonary support for refractory cardiac arrest associated with hyperkalemia or rhabdomyolysis [4,10,11]. In particular, ECMO can be recommended for prolonged refractory cardiac arrest due to reversible etiology because it has shown acceptable survival rates with minimal neurologic damage [4,12].…”

Almost-certain malignant hyperthermia during cardiopulmonary bypass: a case report and literature review

“…6 Furthermore, in cases of MH accompanied by cardiac arrest in spite of immediate treatment with dantrolene sodium, early application of extracorporeal membrane oxygenation (ECMO) for providing cardiopulmonary support may be considered as an effective therapeutic option in order to improve the probability of patient survival when conventional cardiac arrest management has failed. 18,19…”

Perioperative Extracorporeal Cardiopulmonary Resuscitation in Adult Patients: A Review for the Perioperative Physician

“…Case reports have described its use in perioperative arrest due to local anesthetic systemic toxicity, malignant hyperthermia, anaphylaxis, and amniotic fluid, fat, and pulmonary embolism. [43][44][45][46][47][48][49] A recent expert review on perioperative arrest indicates that extracorporeal CPR should be considered for cardiac arrest in the operating room and more specifically for arrest due to local anesthetic systemic toxicity, severe hyperkalemia, anaphylaxis, and pulmonary, gas, or fat embolism. 25,26 Extracorporeal CPR should also be considered for perioperative arrest due to cardiac arrhythmias, myocardial infarction, pulmonary hemorrhage, or loss of airway.…”