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急诊科恶性高热病例报告

Case Report of Malignant Hyperthermia in the Emergency Department.

作者信息

McMurray Mitchell, Sowers Austin, Orthober Raymond, Huecker Martin

机构信息

University of Louisville School of Medicine, Department of Emergency Medicine, Louisville, Kentucky.

出版信息

Clin Pract Cases Emerg Med. 2023 May;7(2):85-88. doi: 10.5811/cpcem.1402.

DOI:10.5811/cpcem.1402
PMID:37285489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10247178/
Abstract

INTRODUCTION

Malignant hyperthermia (MH) is a rare but deadly condition that may be encountered in the emergency department (ED). This report highlights a case of a patient who initially presented for acute agitation with hypertension and tachycardia and provides explanation for how to manage MH.

CASE REPORT

A 44-year-old male presented to the ED with altered mental status, eventually requiring intubation with etomidate and succinylcholine. Despite being afebrile initially, the patient developed a rectal temperature of 105.3° Fahrenheit (F) with significantly elevated arterial carbon dioxide levels after intubation. The treating team initiated cooling measures and dantrolene, leading to a positive outcome.

CONCLUSION

Clinicians should strive for expeditious recognition of MH and treatment with an updated institutional protocol.

摘要

引言

恶性高热(MH)是一种罕见但致命的病症,可能在急诊科(ED)遇到。本报告重点介绍了一名最初因急性躁动伴高血压和心动过速就诊的患者病例,并说明了如何处理恶性高热。

病例报告

一名44岁男性因精神状态改变就诊于急诊科,最终需要使用依托咪酯和琥珀酰胆碱进行插管。尽管最初体温正常,但患者插管后直肠温度升至105.3华氏度(F),动脉二氧化碳水平显著升高。治疗团队启动了降温措施并使用了丹曲林,最终取得了良好的效果。

结论

临床医生应努力迅速识别恶性高热,并按照更新后的机构方案进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e0a/10247178/d28f5c848bc4/cpcem-7-85-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e0a/10247178/d28f5c848bc4/cpcem-7-85-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e0a/10247178/d28f5c848bc4/cpcem-7-85-g001.jpg

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The current status of malignant hyperthermia.恶性高热的现状
J Biomed Res. 2019 May 30;34(2):75-85. doi: 10.7555/JBR.33.20180089.
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Consensus Statement of the Malignant Hyperthermia Association of the United States on Unresolved Clinical Questions Concerning the Management of Patients With Malignant Hyperthermia.美国恶性高热协会关于恶性高热患者管理方面未解决的临床问题的共识声明。
Anesth Analg. 2019 Apr;128(4):652-659. doi: 10.1213/ANE.0000000000004039.
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Succinylcholine Use and Dantrolene Availability for Malignant Hyperthermia Treatment: Database Analyses and Systematic Review.
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Malignant hyperthermia: a review.恶性高热:综述
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