1/31. malignant hyperthermia in a patient with Graves' disease during subtotal thyroidectomy.We report the case of a 31-year-old man with Graves' disease who manifested malignant hyperthermia during subtotal thyroidectomy. His past medical history and family history were unremarkable. Before surgery, his condition was well controlled with propylthiouracil, beta-adrenergic blocker and iodine. During the operation, anesthesia was induced by intravenous injection of vecuronium and thiopental, followed by suxamethonium for endotracheal intubation. anesthesia was maintained with nitrous oxide and sevoflurane. One hour after induction of anesthesia, his end tidal carbon dioxide concentration (ET(CO2)) increased from 40 to 50 mmHg, heart rate increased from 90 to 100 beats per min and body temperature began to rise at a rate of 0.3 degrees C per 15 min. Suspecting thyroid storm, propranolol 0.4 mg and methylprednisolone 1,500 mg were administered, which, however, had little effect. Despite the lack of muscular rigidity, the diagnosis of malignant hyperthermia was made based on respiratory acidosis. Sevoflurane was discontinued and dantrolene was given by intravenous bolus. Soon after the treatment, ET(CO2), heart rate and body temperature started to fall to normal levels. His laboratory findings showed abnormally elevated serum creatine phosphokinase and myoglobin but normal thyroid hormone levels. Since dantrolene is efficacious in thyrotoxic crisis and malignant hyperthermia, an immediate intravenous administration of dantrolene should be considered when a hypermetabolic state occurs during anesthesia in surgical treatment for a patient with Graves' disease.- - - - - - - - - - ranking = 1keywords = respiratory acidosis, acidosis (Clic here for more details about this article) |
2/31. Severe rhabdomyolysis due to malignant hyperthermia during renal transplantation procedure can cause delayed graft function.A case of rhabdomyolysis from malignant hyperthermia occurred during renal transplantation surgery is presented. After the completion of vascular and uretherovesical anostomosis, the patient's heart rate began to rise, sweatiness was observed and body temperature increased to 41 degrees C. Additionally, metabolic and respiratory acidosis and hyperkalemia were detected. serum creatine kinase and lactic dehydrogenase levels were increased significantly. After external cooling and the administration of dantrolene sodium, body temperature and heart rate were decreased. During this period; furosemide, mannitol and sodium bicarbonate were given. Three hours after the completion of surgery, urine output was begun and urine myoglobin was found to be positive. Renal function improved gradually and serum creatinine level decreased to 1.6 mg/dl on the 14th postoperative day. malignant hyperthermia can lead to severe rhabdomyolysis and delayed graft function in renal transplant recipients. early diagnosis and intervention is crucial for protecting renal function.- - - - - - - - - - ranking = 1keywords = respiratory acidosis, acidosis (Clic here for more details about this article) |
3/31. Ascending tonic-clonic syndrome secondary to intrathecal Omnipaque.A 52-year-old man experienced progressive tonic-clonic activity soon after undergoing a myelogram accompanied by an intrathecal injection of Omnipaque. The activity progressed to seizures, hyperthermia, and acidosis. He was intubated, cooled, and treated symptomatically. His creatinine kinase rose to 60,000 IU/L. He eventually recovered completely. This distinct set of clinical signs renders the syndrome easily recognizable. Although this syndrome superficially resembles malignant hyperthermia, the pathophysiology is different. survival depends on prompt recognition and rapid symptomatic treatment. Treatment with dantrolene sodium is not necessary.- - - - - - - - - - ranking = 0.0039864395265401keywords = acidosis (Clic here for more details about this article) |
4/31. Sevoflurane-induced malignant hyperthermia during cardiopulmonary bypass and moderate hypothermia.A 56-year old man was admitted for elective mitral valve repair and coronary artery bypass surgery due to mitral valve leakage and unstable angina. After induction of anaesthesia he developed a combined metabolic and respiratory acidosis. Different diagnosis were considered and we decided to treat the patient with dantrolene due to suspicion of malignant hyperthermia (MH). The patient received one dose of dantrolene 2,5 mg/kg during cardiopulmonary bypass (CPB) and a second dose of dantrolene 2,5 mg/kg during weaning from CPB. The first arterial blood gas sample taken in the intensive care unit showed relapse of the acidosis and we administered an infusion of 150 mg dantrolene over 3 hours. The patient gradually recovered without sequel and MH was verified by muscle biopsy testing.- - - - - - - - - - ranking = 1.0039864395265keywords = respiratory acidosis, acidosis (Clic here for more details about this article) |
5/31. Desflurane, malignant hyperthermia, and release of compartment syndrome.We describe a case of suspected malignant hyperthermia in a healthy 20-yr-old man. The patient underwent urgent release of upper extremity compartment syndrome as a result of traumatic vascular injury. After 3 h of general anesthesia with desflurane, he developed a hypermetabolic state (hypercarbia, hyperthermia, hyperkalemia, and metabolic acidosis), consistent with the diagnosis of malignant hyperthermia. Cardiovascular instability coincided with reperfusion of the injured extremity. Treatment with dantrolene and supporting measures restored cardiovascular stability. Three days later he underwent a successful second surgery under regional block with total IV anesthesia.- - - - - - - - - - ranking = 0.0039864395265401keywords = acidosis (Clic here for more details about this article) |
6/31. malignant hyperthermia following systemic rewarming after hypothermic cardiopulmonary bypass.malignant hyperthermia (MH) is a rare hypermetabolic disorder of skeletal muscle that can be fatal if not recognized and treated aggressively. We describe a patient with a suspected family history of MH who developed hyperpyrexia, acidosis, and hypermetabolism after cardiac surgery despite a nontriggering anesthetic. No drugs were identified as being causative and we theorize that systemic rewarming was the inciting cause of MH in this MH-susceptible individual via a mechanism similar to heat stroke.- - - - - - - - - - ranking = 0.0039864395265401keywords = acidosis (Clic here for more details about this article) |
7/31. Correction of tetralogy of fallot accompanied by malignant hyperthermia. Case report.A 5-year-old girl susceptible to malignant hyperthermia underwent total repair of tetralogy of fallot. The initial operation was canceled because of abrupt hyperthermia and metabolic acidosis of unknown cause. dantrolene was given orally as preoperative treatment and administered intermittently during surgery. Postoperative hyperthermic crisis was successfully treated with intravenous dantrolene combined with surface cooling, gastric tube irrigation with cold saline, and alcohol vaporization.- - - - - - - - - - ranking = 0.0039864395265401keywords = acidosis (Clic here for more details about this article) |
8/31. malignant hyperthermia in an office surgery suite: a case report.malignant hyperthermia is a threat to the life of the surgical patient. It is a pharmacogenic disease that is brought on by contact with certain drugs and is manifest by a hypermetabolic crisis with tachycardia, ventricular ectopy, metabolic acidosis, and a rapid rise in body temperature. muscle rigidity may or may not be present. Thanks to a reliable porcine animal model of malignant hyperthermia, dantrolene sodium has been found to be effective in the prevention and treatment of malignant hyperthermia. In this article a case report of malignant hyperthermia occurring in an office surgery suite is presented. The patient was 37 years old and underwent a routine septorhinoplasty under general anesthesia. The operation was complicated by ventricular ectopy, rapid rise in body temperature, and muscle rigidity at the end of the case. The malignant hyperthermia aborted spontaneously after 30 minutes; dantrolene was not given.- - - - - - - - - - ranking = 0.0039864395265401keywords = acidosis (Clic here for more details about this article) |
9/31. rewarming following hypothermic cardiopulmonary bypass in the malignant hyperthermia-susceptible patient: implications for diagnosis and perioperative management.A 55-year-old, malignant hyperthermia-susceptible patient underwent myocardial revascularization without incident. Six hours postoperatively, he developed what was initially diagnosed as an MH crisis, for which he received intravenous dantrolene. The resultant muscle weakness prolonged the duration of postoperative mechanical ventilation and likely contributed to the development of a postoperative pneumonia. plasma dantrolene levels were measured for the first 48 hours postoperatively and correlated with clinical findings. On reviewing the patient's perioperative course, it was felt that the hypermetabolic state was not due to MH. The patient's pattern of rewarming following hypothermic cardiopulmonary bypass was similar to non-MH-susceptible patients. Because of the difficulty in diagnosing a MH crisis after hypothermic bypass, it is recommended that patients receive prophylactic dantrolene preoperatively and after bypass. Nondepolarizing muscle relaxants should be given postoperatively to prevent shivering and respiratory acidosis while patients rewarm.- - - - - - - - - - ranking = 1keywords = respiratory acidosis, acidosis (Clic here for more details about this article) |
10/31. Phaeochromocytoma--a presentation mimicking malignant hyperthermia.A 52-year-old apparently healthy, normotensive woman who presented for elective cholecystectomy experienced intra-operative hypertension and tachycardia, which were controlled by propranolol. Oesophageal temperature increased, there was a metabolic and respiratory acidosis with hypoxaemia, and malignant hyperthermia was diagnosed. Severe cardiogenic pulmonary oedema ensued, and was treated with intravenous glyceryl trinitrate. ventricular fibrillation caused cardiac arrest, and this was treated successfully. Postoperatively a phaeochromocytoma was discovered, and removed at a subsequent operation. The case illustrates the similarities in presentation of malignant hyperthermia and phaeochromocytoma, and the possibility that misdiagnosis may exacerbate the crisis.- - - - - - - - - - ranking = 1keywords = respiratory acidosis, acidosis (Clic here for more details about this article) |
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