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Malignant hyperthermia in a 6-month-old infant
P R Mathur1, M Rundla2, N Jain1
1Department of Anesthesiology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India.
Saudi Journal of Anaesthesia
|July 5, 2016
Summary
Malignant hyperthermia (MH) is a rare muscle disorder triggered by anesthesia. Early recognition and avoiding triggering agents are crucial for managing MH crises, especially when diagnostic tests are unavailable.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Medical Genetics
Background:
- Malignant hyperthermia (MH) is a rare, life-threatening hypermetabolic skeletal muscle disorder.
- Susceptibility is triggered by anesthetic agents like halothane and succinylcholine.
- Clinical signs include tachycardia, hyperthermia, hypercarbia, acidosis, and muscle rigidity.
Observation:
- The Caffeine Halothane Contracture Test (CHCT) is not widely available in India.
- Larach et al. developed a clinical grading scale for MH raw score assessment.
- A 6-month-old child undergoing laparotomy presented with MH symptoms.
Findings:
- The patient exhibited classic signs and symptoms of malignant hyperthermia.
- The clinical grading scale indicated an MH raw score of 36, corresponding to MH rank 5.
- This case highlights MH occurrence in infants and the utility of clinical scoring in diagnostic limitations.
Implications:
- Emphasizes the importance of high clinical suspicion for MH in pediatric patients.
- Recommends avoiding triggering anesthetic agents and considering total intravenous anesthesia in MH-susceptible individuals.
- Suggests the clinical grading scale as a valuable tool for MH assessment in resource-limited settings.
Keywords:
Halothanemalignant hyperthermiamalignant hyperthermia clinical grading scalesuccinylcholineMore Related Videos
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