Kuntz Michael T, Saab Amanda D
From the Department of Anesthesiology, University of Miami, Jackson Memorial Hospital, Miami, Florida.
Department of Anesthesiology, Division of Pediatric and Adult Congenital Cardiac Anesthesiology, University of Miami, Jackson Memorial Hospital, Miami, Florida.
A A Pract. 2019 Apr 1;12(7):246-248. doi: 10.1213/XAA.0000000000000902.
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.
目前尚无关于接受体外循环（CPB）治疗的儿科患者发生恶性高热的病例报告。我们报告一例10岁接受主动脉瓣置换术的男孩病例。该患者出现进行性心动过速和高碳酸血症。此外，呼气末二氧化碳分压（EtCO2）和动脉血二氧化碳分压（PaCO2）相等，鉴于尿液颜色变深怀疑有肌红蛋白尿。在体外循环期间给予了多次丹曲林推注，并开始输注丹曲林。术后第2天患者的碱缺失和肌酸磷酸激酶恢复正常。该病例证明了快速诊断恶性高热的重要性，以及在治疗体外循环期间血容量被稀释的患者时额外使用丹曲林的必要性。
