Baker, Kevin R.; Landriscina, Donna; Kartchner, Heather; Mirkes, David M.
April 2007
AANA Journal;Apr2007, Vol. 75 Issue 2, p101
Academic Journal
Prompt administration of intravenous (IV) dantrolene sodium (DS) is the primary determinant of successful treatment of malignant hyperthermia (MH) syndrome. Because DS has a long reconstitution time for use in treating an MH crisis, we evaluated an alternative technique for hastening the reconstitution. Simulating real-world conditions, with equipment common to the operating room environment, we conducted a randomized, controlled, single-blind study dividing 16 DS vials into 2 equal groups: warm (41°C) and ambient temperature (22°C). With an IV fluid warmer at 41°C, primed with a 1-L bag of preservative-free sterile water, attached to a 60-mL syringe via a 3-way stopcock, we aspirated and injected the diluent directly into each DS vial. The Icarus effect was clearly demonstrated: warmed diluent vs ambient temperature hastened the reconstitution time for DS. The mean time to particulate-free DS solution suitable for IV injection with the warm diluent was 58.88 seconds compared with 93.87 seconds for the ambient temperature group (P < .001). A practical method using a reliable and safe warming device readily available to anesthetists and ubiquitous to the operating room environment speeds the time to administration of DS ultimately reducing morbidity and mortality associated with MH.


Related Articles

  • Malignant hyperthermia. Morris, David // Independent Nurse;2/21/2011, p23 

    The article offers information on malignant hyperthermia (MH), a rare condition that occurs following the use of general anaesthetic (GA) agents. It outlines the clinical features of MH, including increasing muscle tone that leads to rigidity, tachycardia, hypertension, sweating and skin...

  • Fulminant-type malignant hyperthermia in Japan: cumulative analysis of 383 cases. Migita, Takako; Mukaida, Keiko; Kawamoto, Masashi; Kobayashi, Masako; Yuge, Osafumi // Journal of Anesthesia;2007, Vol. 21 Issue 2, p285 

    We investigated the transition of clinical signs of fulminant-type malignant hyperthermia (f-MH) by analyzing a database consisting of 383 cumulative cases of f-MH from 1961 to 2004. The cases were divided by time period into group 1 (1961–1984), group 2 (1985–1994), and group 3...

  • Babies in Distress. Nnamani, Nwamaka Pamela; Moss, David R. // Clinical Pediatrics;Jun2015, Vol. 54 Issue 6, p557 

    There has been international debate on the infrequent occurrence of malignant hyperthermia in infants, where some reports state that this phenomenon does not exist in this age group; but the vast majority of studies counteract this argument. The proportion of documented cases in the infant...

  • Prevention and treatment of malignant hyperthermia in certified training hospitals in Japan: a questionnaire. Suyama, Hidemichi; Kawamoto, Masashi; Yuge, Osafumi // Journal of Anesthesia;2002, Vol. 16 Issue 3, p207 

    .Purpose. To assess the preparedness of hospitals in Japan for cases of malignant hyperthermia (MH).Method. A survey was sent to 884 training hospitals certified by the Japan Society of Anesthesiologists (JSA) in June and July 2000. Useful answers were received from 431 (48.8%)...

  • Sindrome da Ipertermia Maligna: una revisione bibliograica. SONIA, POLIN; DORIGO, MARA; CORSO, MARILISA // SCENARIO: Official Italian Journal of ANIARTI;2014, Vol. 31 Issue 4, p5 

    No abstract available.

  • Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group. Glahn, K. P. E.; Ellis, F. R.; Halsall, P. J.; Müller, C. R.; Snoeck, M. M. J.; Urwyler, A.; Wappler, F. // BJA: The British Journal of Anaesthesia;Oct2010, Vol. 105 Issue 4, p417 

    Survival from a malignant hyperthermia (MH) crisis is highly dependent on early recognition and prompt action. MH crises are very rare and an increasing use of total i.v. anaesthesia is likely to make it even rarer, leading to the potential risk of reduced awareness of MH. In addition,...

  • Spinal Anesthesia Management in Central Core Disease: A Case Report. Sarihasan, Binnur; Kelsaka, Ebru // Turkish Journal of Medical Sciences;2006, Vol. 36 Issue 6, p393 

    Central core disease is a rare neuromuscular disorder associated with leg weakness. It is a familial disease with autosomal dominant inheritance. Central core disease has been reported to be associated with malignant hyperthermia. A 25-year-old woman with central core disease was scheduled to be...

  • Malignant Hyperthermia Susceptibility and the Trauma Patient. Sheehan, Jacqueline A. // Military Medicine;Jun2005, Vol. 170 Issue 6, p510 

    Assorted casualties are expected from combat. Triage of the wounded may result in some going directly to surgery. Although every minute is essential, anesthetic care of these trauma patients must adhere to all established standards of care. A timely preoperative assessment must include...

  • Malignant Hyperthermia In The Indian Subcontinent: Non-availability Of Dantrolene - A Cause For Concern? Pu, Jyotsna; Bhatnagar, Sushma; saxena, Abha // Internet Journal of Pharmacology;2002, Vol. 1 Issue 1, p3 

    We report the first case of malignant hyperthermia from the Indian sub-continent and raise the issue of non-availability of dantrolene in a country, where this clinical entity was thought not to exist.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics