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How to Treat Malignant Hyperthermia

Medically reviewed by William C Lloyd III, MD, FACS — By Catherine Crider on September 29, 2022Share on Pinterestczardases/Getty ImagesMalignant hyperthermia is a condition that’s often triggered by certain anesthesia drugs and can be life threatening. The condition impacts an estimated 1 in every 100,000 adult surgeries and 1 in 30,000 children’s surgeries, and requires immediate treatment from a team of medical professionals. This article will provide information you can take with you to your doctor’s visits to discuss how to treat malignant hyperthermia.

Stopping medications that trigger malignant hyperthermia

Malignant hyperthermia is typically triggered by drugs used as part of the anesthesia process during a surgical procedure. If signs of malignant hyperthermia occur during surgery while under anesthesia, your doctor will begin administering oxygen and a drug called dantrolene. They will also stop administering all the drugs believed to be triggering the malignant hyperthermia. Your surgeon will end the surgery as quickly as possible.

How is malignant hyperthermia treated

Before anesthesia begins, certain measures are taken to make it easy to quickly treat malignant hyperthermia should it arise. This includes setting up monitoring for:carbon dioxide levels blood oxygen levels core body temperature The operating room will also have processes in place like hypothermia blankets or cold IV fluids to quickly cool the patient. As soon as signs of malignant hyperthermia like elevated temperature, increased heart rate, rapid production of carbon dioxide, and muscle or jaw rigidity are noticed, the surgeon is notified so that they should end the surgery as soon as possible. If the procedure is taking place in a surgical center and not a hospital, emergency help will be called. Use of the triggering drugs will immediately be stopped, and extra oxygen will be supplied through a mask or tube. Dantrolene, the only FDA-cleared medication for treating malignant hyperthermia, will be given to the individual. Dantrolene is a skeletal muscle relaxant that acts by directly interfering with the release of calcium. During a malignant hyperthermia reaction, it’s believed that triggering agents impact the skeletal muscle cells elevating myoplasmic calcium. Dantrolene is thought to prevent or reduce this calcium release. After stopping the triggering drugs and administering dantrolene, medical staff will treat any of the symptoms or complications that have arisen from the malignant hyperthermia. Some examples of complications that may need to be addressed include:extremely high body temperatures trouble breathingirregular heart rhythms Treatment for symptoms and complications might include:using cold IV fluids and ice packs to cool the body from high fevergiving additional oxygen through a tube or maskoffering medications to treat an irregular heartbeat Once the affected individual is stable, they will typically be taken to the intensive care unit (ICU) for at least a day for monitoring. Additional tests will be run in the ICU.

What precautions can be taken afterward

Afterward, the healthcare professional is encouraged to also report the episode to the North American Malignant Hyperthermia Registry of the Malignant Hyperthermia Association of the United States (MHAUS). The individual should wear a medical alert bracelet to notify emergency healthcare professionals of this condition. After experiencing malignant hyperthermia, it’s important for the individual and their genetic relatives to be educated on malignant hyperthermia. This can help them make decisions about genetic testing and better understand other potential triggers like strenuous workouts in extremely hot, humid environments.

What happens if malignant hyperthermia isn t treated

Malignant hyperthermia is a life threatening condition that needs to be treated immediately. If left untreated, it can lead to:cardiac arrestbrain damage internal bleeding failure of other body systems, including the kidneys and livermuscle damageseizurescoma If malignant hyperthermia is left untreated, there is also a possibility of death.

Is treatment different for children vs adults

Symptoms of malignant hyperthermia can vary depending on the individual. Age can be one of the factors that determines which symptoms present and to what degree. As a result, a child may present different combinations of symptoms than an adult experiencing malignant hyperthermia. Regardless of age, once signs of malignant hyperthermia are identified, it’s important for the surgical team to stop use of the triggering drugs, administer dantrolene, and treat any complications or symptoms that malignant hyperthermia has brought on. At this point, age may play a role in treating symptoms and complications. For example, certain medications like those used in the treatment of heart irregularities may not be approved for small children or require different dosages for younger individuals, so age may play a role in how specific symptoms are handled after malignant hyperthermia is addressed.

Takeaway

Malignant hyperthermia is a potentially life threatening condition that requires immediate treatment. Treating this condition includes stopping use of the triggering drugs, administering dantrolene, and addressing any complications or symptoms brought on by the malignant hyperthermia. Malignant hyperthermia typically occurs during a medical procedure while a person is under general anesthesia, so there are usually medical professionals available to take action the moment symptoms appear, which is very important. Last medically reviewed on September 29, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Frequently asked questions (malignant hyperthermia). (n.d.).
mhaus.org/faqs/category/frequently-asked-questions-about/about-mh/Malignant hyperthermia. (2020).
medlineplus.gov/genetics/condition/malignant-hyperthermia/#causesRatto D, et al. (2022). Dantrolene.
ncbi.nlm.nih.gov/books/NBK535398/Watt S, et al. (2022). Malignant hyperthermia.
ncbi.nlm.nih.gov/books/NBK430828/Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 29, 2022 By Catherine Crider Edited By Mike Hoskins Medically Reviewed By William C Lloyd III, MD, FACS Copy Edited By Delores Smith-Johnson Share this articleMedically reviewed by William C Lloyd III, MD, FACS — By Catherine Crider on September 29, 2022

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