Open AccessSíndrome de hipertermia maligna: a propósito de un caso clínico
Author(s) -
Pedro Taffarel,
Fernando Koffman,
Andrea Zifferman,
Sebastián Degiuseppe,
Alejandro Hernández Mansilla,
Marcelo Darduin,
Marcelo Acerenza
Publication year - 2015
Publication title -
archivos argentinos de pediatría
Language(s) - Spanish
Resource type - Journals
SCImago Journal Rank - 0.236
H-Index - 19
eISSN - 1668-3501
pISSN - 0325-0075
DOI - 10.5546/aap.2015.e113
Subject(s) - medicine , hyperkalemia , malignant hyperthermia , dantrolene sodium , dantrolene , anesthesia , rhabdomyolysis , hypercapnia , tachycardia , myopathy , acidosis , calcium
Malignant hyperthermia syndrome is a family myopathy of pharmacogenetic nature, which appears as a skeletal muscle hypercatabolic syndrome linked to anesthesia. The incidence in pediatrics is 1 event per 10 000 surgeries. The clinical picture may have a rapid onset associated with succinylcholine, or a late onset related to inhalation agents. The clinical picture includes tachycardia, hyperthermia, hypercapnia, acidosis, muscle rigidity, hyperkalemia, renal failure and arrhythmia. Mortality without specific treatment is of 80% and drops to 7% with the use of dantrolene sodium. We report an 8-year-old patient admitted for phimosis surgery; having tachycardia, hypercapnia and muscle rigidity, he started treatment with dantrolene sodium in the operating room, which was maintained for 72 hours. He evolved the first 12 hours with low cardiac output and creatine phosphokinase maximum of 155,147 U/L. He remained with mechanical ventilation for 48 hours. Discharge was given on the sixth day without sequelae.