Brief Report: A cardiac surgery protocol for suspected malignant hyperthermia

Cardiac surgery in patients with suspected malignant hyperthermia (MH) susceptibility poses a distinct diagnostic and management challenge, as cardiopulmonary bypass (CPB)-induced hypothermia may mask early manifestations of MH. Given the rarity of this clinical scenario, we present our institutional perioperative protocol-encompassing preoperative workstation decontamination, trigger-free total intravenous anesthesia, CPB-specific precautions, and serial creatine kinase surveillance-illustrated through its successful application in a 47-year-old male undergoing elective four-vessel coronary artery bypass grafting. No clinical or biochemical evidence of MH occurred. We outline this structured approach as a practical reference for the cardiac surgical community.