Malignant hyperthermia (MH) is a rare, life-threatening anesthetic complication caused by dysregulated skeletal muscle calcium homeostasis. We report a 25-year-old trauma patient who developed refractory hypotension with rising Et co 2 despite progressive increases in minute ventilation, followed by hyperthermia, 2.5 hours after exposure to succinylcholine and sevoflurane. Hemodynamic instability was unresponsive to fluids and vasopressors but reversed rapidly after treatment for probable MH with dantrolene (Ryanodex). This case highlights early hemodynamic instability as a prominent manifestation of MH and emphasizes rising Et co 2 despite increased ventilation as a critical diagnostic clue requiring prompt dantrolene administration.
Azar et al. (Mon,) studied this question.