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[Anesthetic malignant hyperthermia and multiple organ dysfunction syndrome].

T Brossier1, N Gwinner, P Fontaine

  • 1Département d'anesthésie-réanimation, centre hospitalier universitaire, 2, boulevard de Lattre-de-Tassigny, BP 1542, 21034 Dijon, France. t.brossier@libertysurf.fr

Annales Francaises D'Anesthesie Et De Reanimation
|September 4, 2001
PubMed
Summary

Malignant hyperthermia from isoflurane anesthesia can lead to multiple organ failure despite dantrolene treatment. This case highlights cardiovascular, liver, and renal failure, with residual muscle weakness.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Malignant hyperthermia is a known hypermetabolic crisis triggered by volatile anesthetics like isoflurane.
  • Dantrolene is the standard treatment for malignant hyperthermia.
  • While explosive malignant hyperthermia is recognized, its progression to multiple organ failure post-dantrolene is less documented.

Observation:

  • A patient developed explosive malignant hyperthermia following isoflurane anesthesia.
  • Despite dantrolene administration, the patient experienced severe cardiovascular compromise.
  • The patient also developed disseminated intravascular coagulation, acute liver failure, and acute kidney injury.

Findings:

  • Isoflurane-induced malignant hyperthermia can precipitate a cascade of organ failures.

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  • Cardiovascular collapse, DIC, and acute liver and renal failure represent severe complications.
  • Complete recovery occurred with only residual right calf muscle weakness.

    • Implications:

    • This case underscores the potential for severe, multi-organ complications in malignant hyperthermia, even with treatment.
    • It emphasizes the need for vigilant monitoring and aggressive management in patients experiencing malignant hyperthermia.
    • Further research may explore predictive factors and optimized treatment strategies for severe malignant hyperthermia presentations.