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Malignant Hyperthermia

CA-1 · I.B.6.i II.A.2.a.1.a II.D.2.i.10

36Sources
21Kept
5Dropped

1 · Find evidence

PubMed query

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36 candidate papers · 17 excluded

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Same-day build

Build failed — did not converge after 3 rebuild rounds (round 2: Codex 3 findings, Opus 1 OVERREACH) -- resume from round 3. failed
PubMed query

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2 · Teaching points

Source

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26 points

Suspected malignant hyperthermia requires immediate treatment with dantrolene, active cooling, and hyperventilation. PMID 39171998 kept
Malignant hyperthermia is a life-threatening reaction triggered by potent inhalational anesthetics or suxamethonium in genetically susceptible individuals. PMID 33399225 kept
An increase in end-tidal carbon dioxide is one of the earliest diagnostic signs of Malignant Hyperthermia. PMID 31040503 kept
Malignant hyperthermia is a potentially fatal complication of general anesthesia. PMID 6359512 kept
This scoping review found that hypercapnia, delayed first temperature measurement, and peak temperature were associated with poor outcomes in malignant hyperthermia. PMID 38148504 kept
This paper found succinylcholine without volatile anesthetics triggered 24 malignant hyperthermia cases, 13 requiring dantrolene, and the data support stocking dantrolene wherever succinylcholine may be used. PMID 30550426 — not confirmed against the abstract: the sentence omits "or volatile anesthetics" from the abstract's recommendation for stocking dantrolene. dropped
This guideline recommends discontinuing triggering agents and administering intravenous dantrolene at 1-2 mg/kg as essential steps in malignant hyperthermia. PMID 41504952 kept
This review states that acute management of malignant hyperthermia necessitates specific management using dantrolene, active cooling, and hyperventilation. PMID 39171998 kept
The guideline provides, for the first time, a consensus definition of a clinical malignant hyperthermia event. PMID 41478797 kept
This retrospective cohort and systematic review found RYR1 or CACNA1S variants in 78% of patients with exertional rhabdomyolysis, suggesting such patients may have increased malignant hyperthermia susceptibility even without prior adverse anesthetic reactions. PMID 28326467 kept
This scoping review found that hypercapnia, delayed first temperature measurement, and peak temperature were associated with poor outcomes in malignant hyperthermia. PMID 38148504 kept
This guideline states that there are no specific clinical features of malignant hyperthermia and the condition may prove fatal unless recognised early and treated promptly and aggressively. PMID 33399225 kept
The JSA guideline recommends discontinuing triggering agents and administering intravenous dantrolene initially at 1-2 mg/kg for malignant hyperthermia. PMID 41504952 kept
This database analysis and systematic review found that succinylcholine without volatile anesthetics triggered twenty-four malignant hyperthermia cases, thirteen requiring dantrolene, and the data support stocking dantrolene wherever succinylcholine may be used. PMID 30550426 kept
This guideline provides for the first time a consensus definition of a clinical malignant hyperthermia event and addresses updated patient referral criteria for suspected cases. PMID 41478797 kept
This retrospective cohort and systematic review found that exertional rhabdomyolysis patients without a history of adverse anesthetic reactions may carry MH-causative mutations, suggesting their possible increased risk for malignant hyperthermia. PMID 28326467 kept
This review states that acute management of malignant hyperthermia necessitates a coordinated multidisciplinary team approach with specific management using dantrolene, active cooling, and hyperventilation. PMID 39171998 — PMID check failed: pubmed 429 for https://eutils.ncbi.nlm.nih.gov/entrez/eutils/esummary.fcgi?db=pubmed&id=39171998&retmode=json&tool=intraop-teaching dropped
This meta-analysis found that succinylcholine without volatile anesthetics triggered 24 malignant hyperthermia cases, 13 requiring dantrolene, supporting the guideline recommendation to stock dantrolene wherever succinylcholine is administered. PMID 30550426 — not confirmed against the abstract: The abstract describes a systematic literature review and database analyses, not a meta-analysis. dropped
This scoping review found that delayed first temperature measurement is associated with poor outcomes in malignant hyperthermia, highlighting the need for early temperature monitoring alongside watching for hyperthermia, sinus tachycardia, and hypercarbia as frequent initial signs. PMID 38148504 — not confirmed against the abstract: adds recommendation for early temperature monitoring not stated in abstract. dropped
This systematic review of malignant hyperthermia-susceptible patients undergoing cardiopulmonary bypass found that aggressive rewarming is associated with the development of clinical signs of malignant hyperthermia and recommends that it not be applied in potentially susceptible individuals. PMID 21376345 — not confirmed against the abstract: The abstract states that rewarming, not specifically aggressive rewarming, is associated with clinical signs. dropped
This 2025 Japanese Society of Anesthesiologists guideline recommends treating suspected malignant hyperthermia by immediately stopping triggering agents and administering an initial intravenous dantrolene dose of 1-2 mg/kg, reflecting a higher initial dose based on international standards. PMID 41504952 kept
This expert review states that malignant hyperthermia presents with early-onset hypercarbia, temperature rise, and muscular rigidity following exposure to inhalational volatile anesthetics and succinylcholine, and recommends acute management with dantrolene, active cooling, and hyperventilation. PMID 39171998 kept
This guideline provides the first consensus definition of a clinical malignant hyperthermia event, establishing a standardized criterion for recognizing suspected cases during anaesthesia. PMID 41478797 kept
This retrospective cohort study and systematic review found that patients with exertional rhabdomyolysis may carry MH-causative RYR1 or CACNA1S variants, suggesting an increased risk for malignant hyperthermia even without a prior adverse anesthetic reaction. PMID 28326467 kept
This guideline states that genetically susceptible individuals are at risk of developing malignant hyperthermia if exposed to any potent inhalational anaesthetics or suxamethonium. PMID 33399225 kept
This review article notes that severe or fulminant cases of drug-induced hyperthermia, including malignant hyperthermia, may evolve into an inflammatory syndrome best described as heat stroke. PMID 36039261 kept

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