Hyperthermia in the pediatric intensive care unit--is it malignant hyperthermia?

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Updated: Jun 20, 2026

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
06:43

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Published on: November 21, 2017

Laura E Schleelein1, Ronald S Litman

  • 1The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Schleelein@email.chop.edu

Paediatric Anaesthesia
|August 22, 2009
PubMed

Insights

Calls to the Malignant Hyperthermia Association of the United States (MHAUS) Hotline for pediatric intensive care unit patients rarely involved Malignant Hyperthermia (MH). Most cases of elevated temperature had other causes, though MH should be considered with anesthetic exposure.

Area of Science:

  • Pediatric Intensive Care
  • Critical Care Medicine
  • Medical Toxicology

Background:

  • Hyperthermia in pediatric intensive care units (ICUs) has diverse causes and is challenging to diagnose.
  • Malignant Hyperthermia (MH) is a rare but life-threatening pharmacogenetic disorder of skeletal muscle.

Purpose of the Study:

  • To characterize calls to the Malignant Hyperthermia Association of the United States (MHAUS) Hotline concerning pediatric patients in the ICU.
  • To identify the causes of elevated temperature in pediatric ICU patients.

Main Methods:

  • A retrospective analysis of MHAUS Hotline logs from 1997-2005 was conducted.
  • Included were pediatric patients (≤18 years) presenting with elevated temperature in an intensive care setting.

Main Results:

  • 3.3% of calls (63/1883) met inclusion criteria.
  • Malignant Hyperthermia (MH) was definite in 5 cases and probable in 3. Infectious and central fever diagnoses accounted for 16 and 9 cases, respectively.
  • Dantrolene was administered in 32 cases; recommendations varied, with some cases involving dantrolene as a nonspecific antipyretic.

Conclusions:

  • Elevated temperature cases in pediatric ICUs reported to MHAUS were infrequently MH-related.
  • While not a common cause, MH must be considered in the differential diagnosis of pediatric hyperthermia, especially after anesthetic exposure.
Abstract

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