Sheng Chuqiao, Yang Chunfeng, Jing Zhe, Li Yumei
Department of Pediatric Intensive Care Unit, First Hospital of Jilin University, Jilin, China.
Department of Laboratory Medicine, First Hospital of Jilin University, Jilin, China.
J Cardiothorac Vasc Anesth. 2021 Nov;35(11):3307-3310. doi: 10.1053/j.jvca.2020.10.055. Epub 2020 Nov 2.
Malignant hyperthermia (MH) is a rare and potentially life-threatening pharmacogenetic disorder encountered during general anesthesia, with the incidence higher in children than in adults. Dantrolene is the specific antagonist of MH, but it is not readily available in China, thus developing alternative treatment protocols is of great practical importance.
Herein, the authors report a two-month-old infant who underwent holmium laser epiglottis retrofitting through a bronchoscope, but developed limb muscular stiffness, tachypnea, tachycardia, and hyperthermia after sevoflurane exposure. After the diagnosis of MH, corresponding supportive treatment was implemented. Because there was no dantrolene available, continuous blood purification and mechanical ventilation were performed. A few days later, the boy recovered without any complications.
Based on the authors' successful clinical practice, the authors consider continuous blood purification as a reliable treatment for MH. But its feasibility still needs to be clarified after multicenter clinical observations.
恶性高热（MH）是一种在全身麻醉期间遇到的罕见且可能危及生命的药物遗传学疾病，儿童发病率高于成人。丹曲林是MH的特异性拮抗剂，但在中国不易获得，因此制定替代治疗方案具有重要的实际意义。
在此，作者报告一名两个月大的婴儿，其通过支气管镜接受了钬激光会厌改造术，但在接触七氟醚后出现肢体肌肉僵硬、呼吸急促、心动过速和高热。诊断为MH后，实施了相应的支持治疗。由于没有丹曲林，进行了持续血液净化和机械通气。几天后，该男孩康复，无任何并发症。
基于作者成功的临床实践，作者认为持续血液净化是治疗MH的可靠方法。但其可行性仍需多中心临床观察后加以明确。
