Master of Science in Nursing (MSN) Student Scholarship

Date Written

Summer 7-1-2017

Document Type

Project

Course Number

N5330

Course Name

Advanced Pathophysiology

Professor’s Name

Dr. Chovan

Keywords

Malignant, Hyperthermia, Anesthesia, Implications, Pathophysiology

Subject Categories

Critical Care Nursing | Medicine and Health Sciences | Nursing | Perioperative, Operating Room and Surgical Nursing

Abstract

Malignant hyperthermia is known as a pharmacogenetic disorder which manifests itself in the skeletal muscle (Heytens, Forget, Scholtès, & Veyckemans, 2015). When a susceptible patient, who carries the autosomal dominant trait, is exposed to volatile anesthetics and/or the neuromuscular blocker succinylcholine, a detrimental response can occur. This response is a hypermetabolic state with hypercapnia, hemodynamic instability, rigidity, hyperthermia, and signs of rhabdomyolysis (Heytens et al., 2015). MH is a rare condition with incidences between 1/5,000 and 1/50,000 (Nagelhout and Plaus, 2014, p. 829), and often occurs during the induction of anesthesia but can also occur intraoperatively or one hour post operatively (Cain, Riess, Gettrust, & Novalija, 2014). Because MH can manifest itself at several different periods during the perioperative phase, CRNA’s must be conscientious health care providers. Incidences occur in patients who carry the mutated autosomal dominant type-1 ryanodine receptor (RYR1) gene (Riazi et al., 2014). If these patients who carry the mutated gene are exposed to triggering agents, and MH is not properly recognized and treated, the result could be irreversible damage and potential death due to the sustained hypermetabolic state the body endures. It is worth exploring the pathophysiology, signs, symptoms, and treatment to prevent this condition from happening.

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