Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- ventilação-minuto aumentada
- temperatura central elevada
- rigidez muscular
Outros fatores diagnósticos
- taquicardia
- débito urinário diminuído
- sudorese excessiva com exercício
- cãibras musculares
- episódios espontâneos de rigidez muscular intensa
Fatores de risco
- exposição a um anestésico inalatório forte e/ou succinilcolina (suxametônio)
- susceptibilidade à HM
- episódio prévio de HM
- história familiar positiva
- doença do esforço por calor
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- descontinuação do anestésico inalatório
- dióxido de carbono exalado, oxigênio e consumo de oxigênio (diferença de concentração do oxigênio inspirado-expirado)
- gasometria venosa
- eletrólitos séricos
- creatinina sérica
- tentativa terapêutica com dantroleno intravenoso
- creatina quinase
- urinálise
- mioglobina urinária
- plaquetas
- tempo de protrombina
Investigações a serem consideradas
- teste de contratura a cafeína-halotano (TCCH)
- teste de contratura in vitro (TCIV)
- teste genético
- rastreamento de deficiências de enzimas musculares
Algoritmo de tratamento
Colaboradores
Autores
Christopher M. Edwards, MD
Assistant Professor
Department of Anesthesiology
University of Florida College of Medicine
Gainesville
FL
Declarações
CME volunteers for the Malignant Hyperthermia Association of the United States (MHAUS), including as a consultant for the malignant hyperthermia hotline. CME is co-author of a chapter on malignant hyperthermia in Fuhrman & Zimmerman’s Pediatric Critical Care, 6th ed., Elsevier.
Nikolaus Gravenstein, MD
Professor
Department of Anesthesiology
University of Florida College of Medicine
Gainesville
FL
Declarações
NG is Medical Director of the North American Malignant Hyperthermia Registry.
Agradecimentos
Christopher M Edwards and Nikolaus Gravenstein would like to gratefully acknowledge Dr Barbara W. Brandom and Dr Lena Mayes, the previous contributors to this topic.
Declarações
LM declares that she has no competing interests. BWB has been reimbursed by the not-for-profit sponsor of the North American MH Registry (NAMHR), the Malignant Hyperthermia Association of the United States (MHAUS) for attending meetings related to the management of the NAMHR. For the past 16 years, BWB received grants from MHAUS to maintain the NAMHR. BWB was the unpaid director of the NAMHR, until Jul 2016. BWB has given lectures and prepared educational materials for her previous employer, the Department of Anesthesiology in the University of Pittsburgh. As of 1 July, 2016, BWB retired from that employment. BWB has published papers and prepared educational materials for MHAUS, with the help of other volunteers for MHAUS. BWB sponsored LM for an award granted by the American Society of Anesthesiologists. This award allowed LM to travel to several medical centers that were active in the diagnosis of MH, as well as to the NAMHR to improve her understanding of this syndrome. This is part of BWB's mentoring of younger anesthesiologists. BWB is also an author of a number of references cited in this topic.
Revisores
Henry Rosenberg, MD
Director
Department of Medical Education and Clinical Research
Saint Barnabas Medical Center
Livingstone
NJ
Declarações
HR declares that he has no competing interests.
Philip Hopkins, MD
Professor of Anesthesia
University of Leeds
Academic Unit of Anesthesia
St James's University Hospital
Leeds
UK
Declarações
PH is an author of a number of references cited in this topic.
Thierry Girard, MD
Associate Professor
Perioperative Patient Safety
Department of Biomedicine
University Hospital Basel
Basel
Switzerland
Declarações
TG declares that he has no competing interests.
Joseph Tobin, MD, FAAP, FCCM
Professor and Chairman
Department of Anesthesiology
Wake Forest University School of Medicine
Winston-Salem
NC
Declarações
JT is an author of a number of references cited in this topic.
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