Última revisão: 23 Out 2020
Última atualização: 29 Jan 2020

Resumo

Definição

História e exame físico

Principais fatores de diagnóstico

  • presença de fatores de risco
  • ventilação-minuto aumentada
  • temperatura central elevada
  • rigidez muscular

Outros fatores de diagnóstico

  • 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

Exames diagnósticos

1° exames a serem solicitados

  • 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
Mais 1° exames a serem solicitados

Exames a serem considerados

  • teste de contratura a cafeína-halotano (TCCH)
  • teste de contratura in vitro (TCIV)
  • teste genético
  • rastreamento de deficiências de enzimas musculares
Mais exames a serem considerados

Algoritmo de tratamento

Colaboradores

Assistant Professor

Department of Anesthesiology

University of Florida College of Medicine

Gainesville

FL

Divulgações

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.

Professor

Department of Anesthesiology

University of Florida College of Medicine

Gainesville

FL

Divulgações

NG is Medical Director of the North American Malignant Hyperthermia Registry.

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.

Divulgações

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.

Colegas revisoresMOSTRAR TODOS

Director

Department of Medical Education and Clinical Research

Saint Barnabas Medical Center

Livingstone

NJ

Divulgações

HR declares that he has no competing interests.

Professor of Anesthesia

University of Leeds

Academic Unit of Anesthesia

St James's University Hospital

Leeds

UK

Divulgações

PH is an author of a number of references cited in this topic.

Associate Professor

Perioperative Patient Safety

Department of Biomedicine

University Hospital Basel

Basel

Switzerland

Divulgações

TG declares that he has no competing interests.

Professor and Chairman

Department of Anesthesiology

Wake Forest University School of Medicine

Winston-Salem

NC

Divulgações

JT is an author of a number of references cited in this topic.

O uso deste conteúdo está sujeito aos nossos avisos legais