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2018, Number 2

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Rev Mex Anest 2018; 41 (2)

Malignant hyperthermia. Bibliographic review

Ortega-García JP, López-Ramírez AY

Language: Spanish
References: 46
Page: 124-132
PDF size: 214.04 Kb.


ABSTRACT

Malignant hyperthermia is a pharmacogenetic myopathy manifested by a hypermetabolic response with an uncontrolled release of calcium from the sarcoplasmic reticulum; It can be triggered in the perioperative by volatile anesthetics and depolarizing muscle relaxants and in an out-of-hospital way due to strenuous physical activities and extreme heat in susceptible people. Its incidence varies from 1:10,000 to 1:250,000 in patients undergo anesthesia. Mutations have been identified in the ryanodine receptor of the skeletal muscle as causing more than 70% of HM cases through the RYR1 gene located on chromosome 19 (19q13.1). Clinical signs of Malignant hyperthermia include tachycardia, hypercapnia, muscle rigidity, hyperthermia, acidosis, hyperkalemia, rhabdomyolysis, hypoxemia, acute renal failure, cardiac arrhythmias, cardiac failure, cardiorespiratory arrest and death. Clinical symptoms are difficult to identify, yet rapid recognition and treatment are crucial to avoiding a fatal outcome. The gold standard for its diagnosis is the caffeine-halothane contracture test, although right now isn’t available in Mexico. The treatment with Dantrolene Sodium has markedly reduced the mortality rate associated with this rare and fatal disease.


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