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Canadian Journal of Anesthesia, Vol 29, 50-54, Copyright © 1982 by Canadian Anesthesiologists' Society

Management of a Malignant Hyperthermia Patient during Cardiopulmonary Bypass

R. J. BYRICK 1, D. K. ROSE 1, and N. RANGANATHAN 2

1 Department of Anaesthesia; University of Toronto and St. Michael's Hospital, Toronto, Ontario
2 Department of Medicine; University of Toronto and St. Michael's Hospital, Toronto, Ontario

Correspondence to: Dr. R.J. Byrick, Department of Anaesthesia, St. Michael's Hospital, 30 Bond Street, Toronto, Canada M5B 1W8.

The anaesthetic management of cardiopulmonary bypass (CPB) for a patient with biopsy-proven malignant hyperthermia is reported. Specific changes in the technique used, such as venting the oxygenator before use, monitoring mixed venous Po2 and Pco2, as well as the safety of cold hyperkalaemic cardioplegia are described. Controversial aspects of malignant hyperthermia management such as the safety of calcium and catechol inotropes are discussed in relationship to the successful use of cardio-pulmonary bypass in our patient. We chose to treat left ventricular dysfunction by aggressive vasodilator (nitroglycerine) therapy. We detected no myocardial or respiratory depression secondary to dantrolene therapy either before or after operation.

Key Words: CARDIAC SURGERY, COMPLICATIONS, malignant hyperthermia






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Copyright © 1982 by the Canadian Anesthesiologists' Society.