The current status of malignant hyperthermia
| Autor: | Alla F. Fomina, Lukun Yang, Timothy J. Tautz, Hong Liu, Shulin Zhang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Hyperkalemia
Sinus tachycardia medicine.drug_class Medical Biotechnology malignant hyperthermia 02 engineering and technology Review Article 01 natural sciences General Biochemistry Genetics and Molecular Biology Dantrolene medicine ryanodine receptor RYR1 business.industry 010401 analytical chemistry Myoglobinuria Malignant hyperthermia Muscle relaxant General Medicine 021001 nanoscience & nanotechnology medicine.disease general anesthesia 0104 chemical sciences Anesthesia medicine.symptom Contracture 0210 nano-technology business dantrolene medicine.drug |
| Zdroj: | Journal of biomedical research, vol 34, iss 2 J Biomed Res |
| Popis: | Malignant hyperthermia (MH) is a rare and life-threatening pharmacogenetic disorder triggered by volatile anesthetics, the depolarizing muscle relaxant succinylcholine, and rarely by strenuous exercise or environmental heat. The exact prevalence of MH is unknown, and it varies from 1:16 000 in Denmark to 1:100 000 in New York State. The underlying mechanism of MH is excessive calcium release from the sarcoplasmic reticulum (SR), leading to uncontrolled skeletal muscle hyper-metabolism. Genetic mutations in ryanodine receptor type 1 ( RYR1) and CACNA1S have been identified in approximately 50% to 86% and 1% of MH-susceptible (MHS) individuals, respectively. Classic clinical symptoms of MH include hypercarbia, sinus tachycardia, masseter spasm, hyperthermia, acidosis, muscle rigidity, hyperkalemia, myoglobinuria, and etc. There are two types of testing for MH: a genetic test and a contracture test. Contracture testing is still being considered as the gold standard for MH diagnosis. Dantrolene is the only available drug approved for the treatment of MH through suppressing the calcium release from SR. Since clinical symptoms of MH are highly variable, it can be difficult to establish a diagnosis of MH. Nevertheless, prompt diagnosis and treatments are crucial to avoid a fatal outcome. Therefore, it is very important for anesthesiologists to raise awareness and understand the characteristics of MH. This review summarizes epidemiology, clinical symptoms, diagnosis and treatments of MH and any new developments. |
| Databáze: | OpenAIRE |
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