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儿童恶性高热的真实证据与误解:一项叙述性综述

Real Evidence and Misconceptions about Malignant Hyperthermia in Children: A Narrative Review.

作者信息

Frassanito Luciano, Sbaraglia Fabio, Piersanti Alessandra, Vassalli Francesco, Lucente Monica, Filetici Nicoletta, Zanfini Bruno Antonio, Catarci Stefano, Draisci Gaetano

机构信息

Department of Scienze dell'Emergenza, Anestesiologiche e della Rianimazione-IRCCS Fondazione Policlinico A. Gemelli, 00168 Rome, Italy.

Department of Critical Care and Perinatal Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Giannina Gaslini, 16147 Genoa, Italy.

出版信息

J Clin Med. 2023 Jun 6;12(12):3869. doi: 10.3390/jcm12123869.

Abstract

Malignant hyperthermia is a rare but life-threatening pharmacogenetic disorder triggered by exposure to specific anesthetic agents. Although this occurrence could affect virtually any patient during the perioperative time, the pediatric population is particularly vulnerable, and it has a five-fold higher incidence in children compared to adults. In the last few decades, synergistic efforts among leading anesthesiology, pediatrics, and neurology associations have produced new evidence concerning the diagnostic pathway, avoiding unnecessary testing and limiting false diagnoses. However, a personalized approach and an effective prevention policy focused on clearly recognizing the high-risk population, defining perioperative trigger-free hospitalization, and rapid activation of supportive therapy should be improved. Based on epidemiological data, many national scientific societies have produced consistent guidelines, but many misconceptions are common among physicians and healthcare workers. This review shall consider all these aspects and summarize the most recent updates.

摘要

恶性高热是一种罕见但危及生命的药物遗传学疾病,由接触特定麻醉剂引发。虽然这种情况在围手术期几乎可能影响任何患者,但儿科人群尤其脆弱,其发病率比成人高五倍。在过去几十年中,领先的麻醉学、儿科学和神经学协会共同努力,产生了有关诊断途径的新证据,避免了不必要的检测并减少了误诊。然而,应改进个性化方法和有效的预防政策,重点是明确识别高危人群、确定围手术期无触发因素的住院治疗以及迅速启动支持性治疗。基于流行病学数据,许多国家科学协会制定了一致的指南,但医生和医护人员中仍存在许多误解。本综述将考虑所有这些方面并总结最新进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f96/10299046/e625f4d39177/jcm-12-03869-g001.jpg

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