Family History of Malignant Hypertension

MmacFN · Jun 10, 2006

Bets place to peek at is here:

http://www.mhaus.org/index.cfm/fuseaction/Content.Display/PagePK/Home.cfm

MH is a genetic problem that can cause an increase in temp every 5 min by 1 degree (or worse). Many of the volatile gasses as well as succs can cause this reaction. Thats why he needs Anesthesia consult, smart doc.

JessP · Jun 10, 2006

Tweety I am sure you realize now that it is M. Hyperthermia. That site is a good place for info. Preparation for surgery in the MH is very important but not a huge ordeal, we had a pt this week with a hx and the case went smoothly.

Jess

Tweety, BSN, RN · Jun 10, 2006

Thanks. The doc wrote malignant HTN in his consult order, but reading his progress notes he says hyperthermia. Another doc below rights HTN again. The kid is already running temps close to 102, which is odd, we usually don't see temps in trauma patients upon admission but the next few days.

I knew I came to the right place. :)

CHATSDALE · Jun 10, 2006

not familiar with m hyperthermia i know that m hpertension can be very a very dangerous condition in an of itself and esp during surgery

Tweety, BSN, RN · Jun 10, 2006

I clarified with the patient and family, it is indeed malignant hyperthermia. He's never had surgery before himself.

susswood · Jun 11, 2006

MH is a genetic problem that can cause an increase in temp every 5 min by 1 degree (or worse). Many of the volatile gasses as well as succs can cause this reaction.

FYI: an increase in temerature is actually a late sign of the disorder. The nomenclature of the disorder can be misleading people to believing it is soley a problem with temperature when it is actually a hypermetabolic state resulting in a severe systemic response. The first signs under anesthesia would be increased ETCO2, tachycardia, HTN and progressing on to metabolic acidosis.... etc. Once the temp starts to increase, it may be too late to reverse.

Anyhow, anesthesia can be administered in such a way as to avoid those agents which are known to "trigger" MH in susceptible individuals.

MmacFN · Jun 11, 2006

Hey suss

Good info. I didnt bother to mention anything about the overall process based on the questions. Ive actually transported 2 patients who had MH. One we found out the hard way after i RSI's him and the second had a realitive tell us so i switched to roc.

Freaky stuff.

FYI: an increase in temerature is actually a late sign of the disorder. The nomenclature of the disorder can be misleading people to believing it is soley a problem with temperature when it is actually a hypermetabolic state resulting in a severe systemic response. The first signs under anesthesia would be increased ETCO2, tachycardia, HTN and progressing on to metabolic acidosis.... etc. Once the temp starts to increase, it may be too late to reverse.
Anyhow, anesthesia can be administered in such a way as to avoid those agents which are known to "trigger" MH in susceptible individuals.

jwk · Jun 12, 2006

Thanks. The doc wrote malignant HTN in his consult order, but reading his progress notes he says hyperthermia. Another doc below rights HTN again. The kid is already running temps close to 102, which is odd, we usually don't see temps in trauma patients upon admission but the next few days.
I knew I came to the right place. :)

The patient's temp now has nothing to do with MH.

MH is an anesthesia phenomenon, and it is inherited. Although it can be treated, there is still significant risk involved, and the best way to avoid the syndrome is to simply avoid the various triggering agents altogether. Simply knowing that there is a strong family history of MH should be enough for the anesthesia providers to deal with this prior to surgery. No other testing is required - they simply alter their anesthesia technique with MH in mind.