A possible means of rapid cooling in the emergency treatment of malignant hyperpyrexia

A possible means of rapid cooling in the emergency treatment of malignant hyperpyrexia, peritoneal dialysis using a cold dialysate, is described. Experimental observations in a young man on a regular peritoneal dialysis regime showed that significant heat extraction can be obtained when either a cool (20 degrees C) or cold (9 degrees C) dialysis fluid is used. The maximum heat exchange observed was 17.5 kJ/min when 2 litre of cold dialysis was instilled for a mean time of 10 min. This rate of heat exchange is within the 10--40 kJ/min range of excess heat production that occurs in malignant hyperpyrexia. Since peritoneal dialysis is, technically, a very quick and simple procedure, it is suggested that it might play a very useful role in the emergency treatment of malignant hyperpyrexia. The dialysis treatment would also correct some of the biochemical disturbances that occur in this condition.