Objectives (Educational Content) :
1. Describe the molecular pathophysiology of malignant hyperthermia.
2. Recognize the early and late clinical findings consistent with malignant hyperthermia.
3. Review the management of malignant hyperthermia in the operating room.
Target Audience:
General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists, and nurses.
Identified Gap:
The American College of Surgeons Committee on Trauma requires a structured effort by trauma programs to demonstrate a continuous process for improving care for injured patients and states that an evidence-based rather than an empiric approach presents more meaningful criteria against which trauma care can be measured. A standardized approach to recurring care issues minimizes unnecessary variation, allow better outcome assessment, and makes changes in care easier to implement and more uniform. They further recommend that all members of the trauma team are knowledgeable about current practices in trauma care, that multidisciplinary education should be ongoing in all trauma centers, and that performance improvement programs should be an important part of educational activities.
Estimated Time to Complete the Educational Activity:
1 hour(s)
Expiration Date for CE/CME Credit:
03-23-2027
Method of Participation in the Learning Process:
The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.
Evaluation Methods:
All learners must successfully complete a post-test, as well as an activity evaluation, to claim CE/CME credit.
Disclosure:
Dr. Bess has indicated that she has no relevant financial interest in any pharmaceutical or medical device company.
Accreditation Statement:
Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.
CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Bibliography:
1. Denborough, M., and Lovell, R., “Anesthetic Deaths in a Family”. The Lancet, 1960; 2: 45-46
2. Kalow, W., Britt, B., Terreau, M., Haist, C., “Metabolic Error of Muscle Metabolism After Recovery from Malignant Hyperthermia”. The Lancet, 1970; 296(7679): 895-898
3. Harrison, G., “Control of the Malignant Hyperpyrexic Syndrome in MHS Swine by Dantrolene Sodium”. British Journal of Anaesthesia, 1975; 47(1): 62-65
4. Mickelson, J., Gallant, E., Litterer, L., Johnson, K., Rempel, W., Louis, C., “Abnormal Sarcoplasmic Reticulum Ryanodine Receptor in Malignant Hyperthermia”. The Journal of Biological Chemistry, 1988; 263(19): 9310-9315
5. Parness J, Lerman J, Stough RC. Malignant Hyperthermia. In: A Practice of Anesthesia for Infants and Children, 2009, Elsevier, Chapter 41, Fourth Edition (edition’s authors: Cote C, Lerman, J, Todres ID), pp. 847-866
6. Rosenberg H, Davis M, James D, Pollock N, Stowell K: “Malignant hyperthermia.” Orphanet J Rare Dis 2007;2:21-35.
7. Larach MG, Brandom BW, Allen GC, Gronert GA, Lehman EB: “Malignant hyperthermia deaths related to inadequate temperature monitoring, 2007-2012: a report from the NAMHR of the Malignant Hyperthermia Association of the US.” Anesth Analg 2014;119:1359-66.
8. Larach et al., 2008; Anesthesiology 108(4): 603-611.
9. Larach MG, Gronert GA, Allen GC, Brandom BW, Lehman EB. Clinical presentation, treatment, and complicationsof malignant hyperthermia in North America from 1987 to 2006. Anesth Analg 2010; 110:498-507.
10. Nelson, T., “Malignant Hyperthermia: A Pharmacogenetic Disease of Ca+2 Regulating Proteins”. Current Molecular Medicine, 2002; 2: 347-369
11. Stowell K. Malignant hyperthermia: a pharmacogenetic disorder. Pharmacogenomics 2008; 9(11): 1657-1672.
12. MHAUS Guidelines. Testing for MH Susceptibility. Slide set available at http://medical.mhaus.org/PubData/PDFs/dx_testing_options.pdf
