John D. Chovan, James R. Cacchillo
Anesthesia, Hyper-metabolic states, Cardiac Dysrhythmias
Anesthesiology | Medical Pathology | Medicine and Health Sciences | Nursing
Surgeries are common, everyday procedures within the walls of America’s hospitals. According to Orser, Mazer, and Baker (2008), more than forty million patients in North America are given anesthetics annually. One of the major complications of anesthesia is malignant hyperthermia: a hyper-metabolic state that affects skeletal muscles. If left uncontrolled, malignant hyperthermia can cause multiple reactions within the body leading to metabolic and respiratory acidosis, cardiac dysrhythmias, kidney failure, coagulopathy, neurologic injury, and ultimately death (Seifert, Wahr, Pace, Cochrane, & Bagnola 2014). The incidence of this condition is estimated to be 1:15,000 in children and 1:20,000-50,000 in adults (Redmond, 2001). Although considered a rare event, the mortality rate of malignant hyperthermia was eighty percent in 1960 and has steadily declined to less than ten percent by 1980 (Saleh, 1992). The concern, however, revolves around the facts that malignant hyperthermia is a hereditary condition that is difficult to screen for prior to the administration of anesthesia, and it occurs in every country and race, male and female, child and adult (Donnelly, 1994). Prompt intervention is crucial and can adequately impede the progression of this heightened metabolic state, yet, delayed action will quickly increase risk of death (Redmond, 2001). Therefore, continued education in regards to the pathophysiology of malignant hyperthermia will aid the surgical team in identifying risk factors, recognizing early signs, and interceding appropriately to protect patients from a potentially life-threatening reaction.
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