[Pharmacological Treatment of Malignant Hyperthermia: Update 2019]. / Maligne Hyperthermie: pharmakologische Therapie Update 2019.
Anasthesiol Intensivmed Notfallmed Schmerzther
; 54(9): 549-558, 2019 Sep.
Article
en De
| MEDLINE
| ID: mdl-31525788
ABSTRACT
Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle presenting as a hypermetabolic response to potent volatile anesthetics such as sevoflurane, desflurane, isoflurane and the depolarizing muscle relaxant succinylcholine. Following introduction of the hydantoin derivative dantrolene, the previously high mortality of fulminant MH episodes could be reduced from > 80% to less than 10%. For treatment of MH an initial intravenous bolus of 2.5 mg/kg dantrolene based on the actual body weight should be applied. If symptoms are not improving after the initial dose, up to 10 mg/kg dantrolene can be necessary within the first 24 h. In facilities where MH triggering anesthetics and depolarizing muscle relaxants are administered, at least 36â-â48 vials of dantrolene 20 mg should be stocked according to the recent German S1 guideline on MH. If none of these agents are ever used in the facility, the stockage of dantrolene is dispensable. Since dantrolene is not easily dissoluble, preparation requires time and manpower. Due to its pharmacological characteristics, ryanodex, a modern nanocrystalline dantrolene sodium suspension, might be a promising alternative in the treatment of MH.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Dantroleno
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Anestésicos
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Hipertermia Maligna
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Fármacos Neuromusculares Despolarizantes
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
De
Revista:
Anasthesiol Intensivmed Notfallmed Schmerzther
Asunto de la revista:
ANESTESIOLOGIA
/
MEDICINA DE EMERGENCIA
/
TERAPIA INTENSIVA
Año:
2019
Tipo del documento:
Article