Key result
Dantrolene boluses and infusion successfully treated presumed malignant hyperthermia in a 10-year-old boy on cardiopulmonary bypass, with normalization of base deficit and CPK by postoperative day 2.
Case Report (n=1)
This case highlights the successful treatment of presumed malignant hyperthermia with dantrolene during cardiopulmonary bypass in a pediatric patient, emphasizing the need for additional dosing due to blood volume dilution.
Documents first MH case during pediatric CPB; leaves open optimal recognition and dantrolene protocols.
There are no case reports of malignant hyperthermia in pediatric patients treated on cardiopulmonary bypass (CPB). We report the case of a 10-year-old boy undergoing aortic valve replacement. The patient developed progressive tachycardia and hypercarbia. In addition, EtCO2 and PaCO2 were equal and myoglobinuria was suspected given darkened urine. Numerous dantrolene boluses were given on CPB, and a dantrolene infusion was started. The patient's base deficit and creatine phosphokinase normalized by postoperative day 2. This case demonstrates the importance of expeditious diagnosis of malignant hyperthermia, and the need for additional dantrolene when treating patients whose blood volume is diluted on CPB.
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Kuntz et al. (2018) conducted a case report in Malignant hyperthermia during cardiopulmonary bypass (n=1). Dantrolene was evaluated on Normalization of base deficit and creatine phosphokinase. Dantrolene boluses and infusion successfully treated presumed malignant hyperthermia in a 10-year-old boy on cardiopulmonary bypass, with normalization of base deficit and CPK by postoperative day 2.
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