scholarly journals Comparison of the caffeine skinned fibre tension (csft) test with the caffeine-halothane contracture (chc) test in the diagnosis of malignant hyperthermia

1982 ◽  
Vol 29 (6) ◽  
pp. 550-562 ◽  
Author(s):  
Beverley A. Britt ◽  
Wanda Frodis ◽  
Elizabeth Scott ◽  
Mary-Jean Clements ◽  
Laszlo Endrenyi
Keyword(s):  
Malignant Hyperthermia ◽  
Fibre Tension ◽  
Skinned Fibre

scholarly journals Effects of Propofol on Calcium Homeostasis in Human Skeletal Muscle

2009 ◽  
Vol 37 (3) ◽  
pp. 415-425 ◽  
Author(s):  
T. Migita ◽  
K. Mukaida ◽  
H. Hamada ◽  
M. Kobayashi ◽  
I. Nishino ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Sarcoplasmic Reticulum ◽  
Malignant Hyperthermia ◽  
Calcium Homeostasis ◽  
Skeletal Muscles ◽  
Autosomal Dominant ◽  
Channel Blocker ◽  
Ryanodine Receptors ◽  
Muscle Disorder ◽  
Skinned Fibre

Malignant hyperthermia is a pharmacogenetic skeletal muscle disorder of intracellular calcium (Ca2+) homeostasis with an autosomal dominant inheritance. The objective of this study was to investigate the safety of propofol by investigating its effects on calcium homeostasis and its effect sites in human skeletal muscles. Muscle specimens were obtained from 10 individuals with predisposition to malignant hyperthermia. In skinned fibre experiments, we measured the effects of propofol on the Ca2+-induced Ca2+ release and the uptake of Ca2+ into the sarcoplasmic reticulum. Ca2+ imaging in primary myotubes was employed to analyse propofol-mediated alternations in the Ca2+ regulation and propofol-induced Ca2+ responses in the presence of Ca2+ channel blocker or Ca2+-induced Ca2+ release inhibitor. Increased Ca2+ release from the sarcoplasmic reticulum and inhibition of Ca2+ uptake into the sarcoplasmic reticulum were not observed with 100 μM propofol. A rise of Ca2+ was not seen under 100 μM propofol and the EC50 value for propofol was 274.7±33.9 μM, which, is higher than the clinical levels for anaesthesia. Propofol-induced Ca2+ responses were remarkably attenuated in the presence of Ca2+ channel blocker or Ca2+-induced Ca2+ release inhibitor compared with the results obtained with caffeine. We conclude firstly that propofol is safe for individuals with predisposition to malignant hyperthermia when it is used within the recommended clinical dosage range, and secondly that its mode of action upon ryanodine receptors is likely to be different from that of caffeine.

Malignant Hyperthermia

1991 ◽  
Vol 3 (1) ◽  
pp. 129-134
Author(s):  
Ginger Schafer Wlody
Keyword(s):  
Malignant Hyperthermia

Malignant hyperthermia susceptibility: utilization of genetic results in an electronic medical record to increase safety

2020 ◽  
Vol 21 (17) ◽  
pp. 1207-1215
Author(s):  
Jordan F Baye ◽  
Natasha J Petry ◽  
Shauna L Jacobson ◽  
Michelle M Moore ◽  
Bethany Tucker ◽  
...  
Keyword(s):  
Decision Support ◽  
Malignant Hyperthermia ◽  
Clinical Decision Support ◽  
Perioperative Complications ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Malignant Hyperthermia Susceptibility ◽  
Alert System ◽  
Genotyping Platform

Aim: This manuscript describes implementation of clinical decision support for providers concerned with perioperative complications of malignant hyperthermia susceptibility. Materials & methods: Clinical decision support for malignant hyperthermia susceptibility was implemented in 2018 based around our pre-emptive genotyping platform. We completed a brief descriptive review of patients who underwent pre-emptive testing, focused particularly on RYR1 and CACNA1S genes. Results: To date, we have completed pre-emptive genetic testing on more than 10,000 patients; 13 patients having been identified as a carrier of a pathogenic or likely pathogenic variant of RYR1 or CACNA1S. Conclusion: An alert system for malignant hyperthermia susceptibility – as an extension of our pre-emptive genomics platform – was implemented successfully. Implementation strategies and lessons learned are discussed herein.

An in-Vitro Model of Malignant Hyperthermia

1979 ◽  
Vol 23 (1) ◽  
pp. 31
Author(s):  
S. B. REED ◽  
G. E. STROBEL
Keyword(s):  
Malignant Hyperthermia ◽  
In Vitro Model ◽  
Vitro Model

scholarly journals Postoperative malignant hyperthermia confirmed by calcium-induced calcium release rate after breast cancer surgery, in which prompt recognition and immediate dantrolene administration were life-saving: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Natsumi Miyazaki ◽  
Takayuki Kobayashi ◽  
Takako Komiya ◽  
Toshio Okada ◽  
Yusuke Ishida ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Temperature ◽  
Malignant Hyperthermia ◽  
Muscle Biopsy ◽  
Release Rate ◽  
Calcium Release ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Body Cooling ◽  
Calcium Induced Calcium Release

Abstract Background Malignant hyperthermia (MH) is a rare genetic disease characterized by the development of very serious symptoms, and hence prompt and appropriate treatment is required. However, postoperative MH is very rare, representing only 1.9% of cases as reported in the North American Malignant Hyperthermia Registry (NAMHR). We report a rare case of a patient who developed sudden postoperative hyperthermia after mastectomy, which was definitively diagnosed as MH by the calcium-induced calcium release rate (CICR) measurement test. Case presentation A 61-year-old Japanese woman with a history of stroke was hospitalized for breast cancer surgery. General anesthesia was introduced by propofol, remifentanil, and rocuronium. After intubation, anesthesia was maintained using propofol and remifentanil, and mastectomy and muscle flap reconstruction surgery was performed and completed without any major problems. After confirming her spontaneous breathing, sugammadex was administered and she was extubated. Thereafter, systemic shivering and masseter spasm appeared, and a rapid increase in body temperature (maximum: 38.9 °C) and end-tidal carbon dioxide (ETCO2) (maximum: 59 mmHg) was noted. We suspected MH and started cooling the body surface of the axilla, cervix, and body trunk, and administered chilled potassium-free fluid and dantrolene. After her body temperature dropped and her shivering improved, dantrolene administration was ended, and finally she was taken to the intensive care unit (ICU). Body cooling was continued within the target range of 36–37 °C in the ICU. No consciousness disorder, hypotension, increased serum potassium level, metabolic acidosis, or cola-colored urine was observed during her ICU stay. Subsequently, her general condition improved and she was discharged on day 12. Muscle biopsy after discharge was performed and provided a definitive diagnosis of MH. Conclusions The occurrence of MH can be life-threatening, but its frequency is very low, and genetic testing and muscle biopsy are required to confirm the diagnosis. On retrospective evaluation using the malignant hyperthermia scale, the present case was almost certainly that of a patient with MH. Prompt recognition and immediate treatment with dantrolene administration and body cooling effectively reversed a potentially fatal syndrome. This was hence a valuable case of a patient with postoperative MH that led to a confirmed diagnosis by CICR.

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