Abstract
Malign hipertermi inhalasyon ajanları, özellikle halojenli olanlar ve/veya süksinilkolin gibi kas depolarizasyonu sağlayan ajanlara maruz kalmaya bağlı olarak oluşan genetik bir sendromdur. Malign hipertermi genellikle anestezi indüksiyonunu takiben görülür, ancak girişim süresince ve sonrasında dahi ortaya çıkabilir. Operasyon sonrası dönemde görülen ağrı ve stres tetikleyici olabilir. 6 aylık nöroblastom nedeni ile opere edilen hasta operasyondan sonra antipiretiklere dirençli ve giderek yükselen ateş, solunum sıkıntısı nedeni ile yoğun bakıma alındı. Takibinde hiperpotasemi ,hiperkarbi, derin metabolik asidoz, serum kreatin fosfokinaz ve transaminaz değerlerinde aşırı yükselme tespit edildi. Başta santral sinir sistemi olmak üzere karaciğer ve böbrek yetmezliğine bağlı multiorgan yetmezliği gelişti. Dantrolen sodyum bulunamayan hasta destek tedavileri ile tedavi edilerek taburcu edildi. Bu olgu ile malign hipertermide postoperatif dönemde tanı ve tedavi yöntemleri tartışılmak istendi.
Keywords
References
- Hopkins PM. Malignant hyperthermia: advances in clinical mana- gement and diagnosis. Br J Anesthesia 2000;85:118-128.
- Brownell AK. Malignant hyperthermia: relationship to other dia- seases. Br J Anesthesia 1988;60:303-308.
- Kayhan Z. Klinik Anestezi.Genişletilmiş 3. Baskı. Ankara: Logos Yayıncılık, 2004: 452-451.
- Yeler H, Özan F, Özan Ü, Yeler D. Malignant Hipertermi. Cumhu- riyet Üniversitesi Diş Hekimliği Fakülte Dergisi 2005;8:138-145. Girnberg R, Edelist G, Gordon A. Postoperative malignant hyperthermia episodes in patients who received “ safe” anaesthe- tics. Can Anaesthe Soc J 1983;30:273.-276.
- Schnorr C, Müller H, Menges T, Bachman-Mennenga B, Hem- pelmann G. Hyperthermic reaction in preoperative phase in 2 children with acute lymphoblastic leukemia of B-cell type. Ana- esthesist 1989;38:85-88.
- Lees D, Gadde Pl, Macnamara TE. Malignant hyperthermia as- sociation with Burkitt ‘s lymphoma: report of third case. Anesth Analg 1980;59:514-515.
- Mayhew JF. Intraoperative hyperthermia in a child with neuroblas- toma. Pediatric Anesthesia 2006;16:890-891.
- Wappler F. Malignant Hyperthermia. Eur J Anaesthesiol 2001;18;632-652.
- Ali SZ, Taguchi A, Rosenberg H. Malignant hyperthermia. Best Pract Res Clin Anaesthesiol 2003;17:519-533.
- Gönüllü M, Ergüngör MF. Malign hipertermi.Türk Nöroşiruruji Dergisi 1989;1:33-36.
- Larach MG, Rosenberg H, Larach DR, Broennle AM. Prediction of malignant hyperthermia suspectibility by clinical signs. Anest- hesiology 1987;66:547-550.
- Özyurt G, Şahin S, Uluçay M. Bir olgu nedeniyle dantrolen teda- visinin yan etkileri. Türk Anesteziyoloji ve Reanimasyon Dergisi 1988;16:156-159.
Abstract
Malignant hyperthermia is a genetic syndrome that is due to exposure to potent inhaled general anesthetics (halothane, isoflurane, sevoflurane) and/or depolarizing muscle relaxant succinycoline. It occurs generally after the induction of general anesthesia, but it may emerge during or even after the operation. Postoperative pain and stress may be the predisposing factors. A 6-month-old baby was admitted to ICU for his fever resistant to antipiretics and progressive inspiratory distress after a neuroblastoma operation. On the follow up, hyperpotassemia, hypercarbi, severe metabolic acidosis, increased kreatinine and transaminase levels were detected . A multiorgan failure beginning primarily in the central nervous system, involved hepatobiliary and urinary systems. The patient was succesfully treated with supportive therapy despite the absence of dantrolene. early diagnosis and treatment of malign hyperthermia in postoperative period is discussed in the contesat of this case report
Keywords
References
- Hopkins PM. Malignant hyperthermia: advances in clinical mana- gement and diagnosis. Br J Anesthesia 2000;85:118-128.
- Brownell AK. Malignant hyperthermia: relationship to other dia- seases. Br J Anesthesia 1988;60:303-308.
- Kayhan Z. Klinik Anestezi.Genişletilmiş 3. Baskı. Ankara: Logos Yayıncılık, 2004: 452-451.
- Yeler H, Özan F, Özan Ü, Yeler D. Malignant Hipertermi. Cumhu- riyet Üniversitesi Diş Hekimliği Fakülte Dergisi 2005;8:138-145. Girnberg R, Edelist G, Gordon A. Postoperative malignant hyperthermia episodes in patients who received “ safe” anaesthe- tics. Can Anaesthe Soc J 1983;30:273.-276.
- Schnorr C, Müller H, Menges T, Bachman-Mennenga B, Hem- pelmann G. Hyperthermic reaction in preoperative phase in 2 children with acute lymphoblastic leukemia of B-cell type. Ana- esthesist 1989;38:85-88.
- Lees D, Gadde Pl, Macnamara TE. Malignant hyperthermia as- sociation with Burkitt ‘s lymphoma: report of third case. Anesth Analg 1980;59:514-515.
- Mayhew JF. Intraoperative hyperthermia in a child with neuroblas- toma. Pediatric Anesthesia 2006;16:890-891.
- Wappler F. Malignant Hyperthermia. Eur J Anaesthesiol 2001;18;632-652.
- Ali SZ, Taguchi A, Rosenberg H. Malignant hyperthermia. Best Pract Res Clin Anaesthesiol 2003;17:519-533.
- Gönüllü M, Ergüngör MF. Malign hipertermi.Türk Nöroşiruruji Dergisi 1989;1:33-36.
- Larach MG, Rosenberg H, Larach DR, Broennle AM. Prediction of malignant hyperthermia suspectibility by clinical signs. Anest- hesiology 1987;66:547-550.
- Özyurt G, Şahin S, Uluçay M. Bir olgu nedeniyle dantrolen teda- visinin yan etkileri. Türk Anesteziyoloji ve Reanimasyon Dergisi 1988;16:156-159.
Details
| Other ID | JA46KU97VB |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2009 |
| Submission Date | June 1, 2009 |
| Published in Issue | Year 2009 Volume: 3 Issue: 3 |
The publication language of Turkish Journal of Pediatric Disease is English.
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