Advanced Pathophysiology for APN
Inhaled anesthetics, Volatile anesthetics, Ryanodine receptor, Hypermetabolic state, Intraoperative complications, Perioperative Setting
Medicine and Health Sciences | Nursing
Malignant hyperthermia (MH) is a rare, life-threatening, and rapidly progressing disorder of the skeletal muscle tissue. It can be induced with the use of neuromuscular blocking agents and inhaled anesthetics which are frequently used by anesthesia providers. The pathophysiology of MH involves an uncontrolled release of free calcium from the ryanodine receptor that is found in the sarcoplasmic reticulum leading to a hypermetabolic state. MH has hereditary significance due to mutation of the ryanodine receptor, thus genetic testing and MH contracture biopsy should be performed to assess susceptibility. Signs and symptoms present as tachycardia. labile blood pressure, hyperthermia, elevated carbon dioxide production, metabolic acidosis, and muscle rigidity. MH needs to be prompt and immediate to address this condition. Intervention includes discontinuation of triggering agents, high-flow oxygenation, body cooling, and pharmacologic therapies (e.g., dantrolene sodium, sodium bicarbonate, antiarrhythmic, insulin, or blood products). Early intervention of MH supersedes the use of pharmacologic methods to prevent the progression of this condition.
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Nyirenda, Luther, "Malignant Hyperthermia" (2022). Nursing Student Class Projects (Formerly MSN). 499.