Synonyms
- Malignant hyperpyrexia,
- MH crisis
Introduction
The full picture of malignant hyperthermia is a very serious metabolic derailment that occurs almost exclusively in connection with anesthesia. Here, a disorder in the calcium balance of the muscle cell, which is symptom-free in everyday life, leads to a massive disturbance of the overall metabolism after contact with certain anaesthetic drugs, with cardiac arrhythmia, oxygen deficiency, hyperacidity and massive overheating of the body. As a result, coagulation disorders, muscle damage, overhydration of the lungs, kidney failure and damage to the brain and nervous system can occur and threaten the patient’s life. Untreated, such a malignant hyperthermia crisis is fatal in 70 – 80% of cases, and through consistent and early therapy, mortality could be reduced to below 5%. It is important to document a crisis that has occurred so that other anesthetics that do not trigger malignant hyperthermia can be used in later operations.
Definition of malignant hyperthermia
Malignant hyperthermia is a massive metabolic disorder in which the energy, oxygen and acid-base balance of the body is derailed in patients with a predisposition to this disorder through contact with certain drugs during anesthesia.
Epidemiology
The frequency of a predisposition to malignant hyperthermia is estimated at about 1/10,000 in the population. The full picture of the disease occurs with one of 250,000 to 500,000 anesthesia, suspected cases occur in about 1/30,000 anesthesia. Men of younger age are more frequently affected overall.
Causes of malignant hyperthermia
Malignant hyperthermia is a not yet fully researched disorder of the calcium balance of the muscle cell, which remains symptom-free in everyday life. The contact with certain triggers, especially gaseous anaesthetics and drugs that relax the muscles during anaesthesia, leads to an acutely occurring disregulation of the calcium balance of the muscle cells, which leads to a flooding of the cell interior with calcium. This initiates highly energy-intensive processes in the musculature, which have far-reaching consequences for the entire organism through the consumption of energy sources, oxygen and the resulting breakdown products: Oxygen and energy carriers that are consumed in the muscles are no longer available to other organs, the body overacidifies due to oxygen debt and degradation products, respiration and mineral balance of the body derail and the body temperature rises sharply, which additionally disturbs the control circuits of the organism and triggers malignant hyperthermia.
