Schatke H, Schneider J, Abbushi W, Schneck H J
Institut für Anästhesiologie, Technische Universität München, Klinikum rechts der Isar.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1991 Dec;26(8):468-70. doi: 10.1055/s-2007-1000618.
The authors report on the course of a fulminant malignant hyperthermia (MH) associated with laminectomy in a 29-year-old man who had been healthy up to that time. Succinylcholine and isoflurane were considered to be the causative triggering agents. Progression could be prevented due to an early suspicion raised by end-expiratory CO2 measurement: treatment was instituted immediately (Dantrolene 2mg/kg body weight, oxygen hyperventilation, external cooling, etc.) Serum creatine kinase increased up to almost 50,000 U/l associated with massive myoglobinuria. Residue-free restitution was achieved within a few days. Decisive for an early detection of MH is the routine performance of end-expiratory CO2 measurement which is definitely superior to temperature control and significantly reduces the time that elapses before treatment is initiated.
作者报告了一名29岁男性在进行椎板切除术时发生暴发性恶性高热（MH）的病例过程，该男子在此之前一直身体健康。琥珀酰胆碱和异氟烷被认为是引发因素。由于呼气末二氧化碳测量早期引发怀疑，病情进展得以预防：立即开始治疗（丹曲林2mg/kg体重、高氧通气、外部降温等）。血清肌酸激酶升高至近50,000 U/l，并伴有大量肌红蛋白尿。数天内实现了无后遗症恢复。呼气末二氧化碳测量的常规操作对于早期发现MH至关重要，其肯定优于体温监测，且显著缩短了开始治疗前的时间。
