Malignant Hyperthermia

Area of Science:

• Critical Care Medicine
• Anesthesiology
• Pharmacology

Background:

• Malignant hyperthermia (MH) is a rare, life-threatening pharmacogenetic disorder.
• It is triggered by volatile anesthetics and succinylcholine in susceptible individuals.
• MH presents with hyperthermia, hypercarbia, and muscle rigidity.

Purpose of the Study:

• To review the clinical epidemiology of MH in critically ill patients.
• To summarize current management strategies for MH.
• To highlight the importance of recognizing and managing MH in intensive care units (ICUs).

Main Methods:

• A narrative expert review was conducted.
• Medline searches identified relevant articles on MH epidemiology, pathophysiology, and management.
• Guidelines from key MH organizations were incorporated.

Main Results:

• MH is a severe reaction with rapid onset, characterized by temperature rise, hypercarbia, and rigidity.
• Complications include coagulopathy, rhabdomyolysis, and acute kidney injury.
• Management involves dantrolene, active cooling, and hyperventilation, requiring a multidisciplinary approach.

Conclusions:

• Increased use of volatile anesthetics in ICUs necessitates better MH education.
• Enhanced diagnosis and management are vital for patient safety and sedation care.
• Suspected MH requires specialized testing and counseling for patients and families.