- . !
- 100% .
- / 2-3 /. 10 / .30
- / 1-3 / 3-.
- . / 15 / 10 3 , , , , .
- / (0,5 / 0,15 / ), CaCl2 2-5 /.
- / (1 // 15 /) (1 /). .31
- ( 1 //) / 0,5 / ( 150 ) (0,5-1,0 /). .
- .
- .
- - , , (Na, K, Ca, Cl, P) ( 10 ), , ( ).
- .
, .
- 24 .
- 1,0 / 6 24-48 .
- , , , . 6 . .
, .
MHAUS : (209) 634-4917, . : 1-800-98-MHAUS 607-674-7901.
: 1-315-428-7924.
. , , , , - .32 , . , , . - , , .3
|
|
. MHAUS , 36 .2,19 (. ) . , 10 / 20 / . 20 / , , . , . .2
, . 3 .
, , - . , . , . , , , , . .2 , , - .
. .
1975 .4 , , 1979 , / . , .2 / 6-20 . 5-6 .34 7-10 , 12 . . 34
, 2+ , , , . . 3
|
|
, . , , . , . , , , , . , . , , , , .2
3
() . . , . , , .
:
- , , .
- .
- .
- .
: , , , , . , - - .
(. ). .
. , , . :
- .
- .
- .
- .
- 10 / 10 . - .33
3-4 , . 35
- . - 40 , 15 20 . (MHAUS) , , . : , > 0,2 , > 0,3 . , 3% > 0,7 > 0,5 .2,4,37 , 100% 78% .2,38,39
|
|
-, . . 2
, , , , , , . , . 2
, , . . .
, : 1) , , 2) , 3) , 4) . , . , , . , . , . , , , .
, - , MHAUS. , , .
, . , . , , . , , .
|
|
, .
- Denborough MA, Lovell RRH: Anaesthetic deaths in a family [letter], Lancet 2:45, 1960.
- Kaplan RF: Malignant hyperthermia, ASA Refresher Courses in Anesthesiology, Philadelphia, 1994, JB Lippincott Co.
- Bell C, Kain ZN, ed: The Pediatric Anesthesia Handbook, 2nd Edition, St. Louis, 1997, Mosby-Year Book, pp. 485-500.
- Sessler DI: Temperature regulation. In Gregory GA, ed: Pediatric Anesthesia, 3rdEdition, New York, 1994, Churchill Livingstone Inc., pp. 47-59.
- Rosenberg H, Fletcher JE: Malignant hyperthermia. In Barash PG, ed: ASA Refresher Courses in Anesthesiology, vol 14, Philadelphia, 1986, JB Lippincott Co., pp. 207-216.
- Schmitt HP, Simmendinger HJ, Wagner H, et al: Severe morphological changes in skeletal muscles of a five-month old infant dying from an anesthetic complication with general muscle rigidity, Neuropadiatrie 6:102, 1975.
- Mayhew JF, Rudolph J, Tobey RE: Malignant hyperthermia in a six month old infant: a case report, Anesth Analg 57:262, 1978.
- Ording H: Incidence of malignant hyperthermia in Denmark, Anesth Analg 64:700-704, 1985.
- Wingard DW: A stressful situation [Editorial], Anesth Analg 59:321, 1980.
- Http://www.mhaus.org 1998. ( )
- Levitt RC: Prospects for the diagnosis of malignant hyperthermia susceptibility using molecular genetic approaches, Anesthesiology 76:1039-1048, 1992.
- MacLennan DH, Phillips MS: Malignant hyperthermia, Science 256:789-794, 1992.
- Williams CH, Lasley JH: The mode of inheritance of the fulminant hyperthermia stress syndrome in swine. In Henschel EO, ed: Malignant hyperthermia: current concepts, New York, 1977, Appleton-Century-Crofts, p.141.
- Wieland SJ, Fletcher JE, Rosenberg H, Gong QH: Malignant hyperthermia: Slow sodium current in cultured human muscle cells, Am J Physiol 257:C759-C765, 1989.
- Schulman S: Malignant hyperthermia and pediatric anesthesia, Semin Anesth 12:54-64, 1993.
- Heiman-Pattersohn TH, Natter H, Rosenberg H, et al: Malignant hyperthermia susceptibility in x-linked muscle dystrophies, Pediatr Neurol 2:356, 1987.
- Brownell AKW: Malignant hyperthermia: Relationship to other diseases, Br J Anaesth 60:303-308, 1988.
- Http://mh.hiroshima-u.ac.jp/Documentation 1997. ( )
- Preventing malignant hyperthermia: an anesthesia protocol, Malignant Hyperthermia Association of the United States (MHAUS), 1993.
- Strazis KP, Fox AW: Malignant hyperthermia: a review of published cases, Anesth Analg 77:297-304,1993.
- Gronert GA: Human malignant hyperthermia: Awake episodes and correction with dantrolene, Anesth Analg 59:377-378, 1980.
- Murphy AL, Conlay L, Ryan JF, Roberts JT: Malignant hyperthermia during a prolonged anesthetic for reattachment of a limb, Anesthesiology 60:149-150, 1984.
- Littleford JA, Patel MA, Bose D, Cameron CB, McKillop C: Masseter muscle spasm in children: implications of continuing the triggering anesthetic, Anesth Analg 72:151-160, 1991.
- Schwartz L, Rockoff MA, Koka BV: Masseter spasm with anesthesia: incidence and implications, Anesth Analg 72:151-160, 1991.
- Larach MG, Rosenberg H, Larach DR, Broennle AM: Prediction of malignant hyperthermia susceptibility by clinical signs, Anesthesiology 66:547-550, 1987.
- Hannallah RS, Kaplan RF: Jaw relaxation after a halothane/succinylcholine sequence in children, Anesthesiology 81:99-103, 1994.
- OFlinn RP, Shutack JG, Rosenberg H, Fletcher JE: Masseter muscle rigidity and malignant hyperthermia susceptibility in pediatric patients: an update on management and diagnosis, Anesthesiology 80:1228-1233, 1994.
- Barlow MB, Isaacs H: Malignant hyperpyrexial deaths in a family Reports of three cases, Br J Anesth 42:1072-1076, 1970.
- Emergency therapy for malignant hyperthermia, Malignant Hyperthermia Association of the United States (MHAUS), 1993.
- Ryan JF: Malignant hyperthermia: treatment and after care, Anesth Clin North Am 4:913-932, 1991.
- Rubin AS, Zablocki AD: Hyperkalemia, verapamil, and dantrolene, Anesthesiology 66:246-249, 1987.
- Reber A, Schumacher P, Urwyler A: Effects of three different types of management on the elimination kinetics of volatile anesthetics, Anaesthesia 48:862-865, 1993.
- Beebe JJ, Sessler DI: Preparation of anesthesia machines for patients susceptible to malignant hyperthermia, Anesthesiology 69:395-400, 1988.
- Harrison GG: Dantrolene: dynamics and kinetics, Br J Anaesth 60:279-286, 1988.
- Yentis SM, Levine MF, Hartley EJ: Should all children with suspected or confirmed malignant hyperthermia susceptibility be admitted after surgery? A 10-year review, Anesth Analg 75:345-350,1992.
- Guze BH, Baxter LR: Neuroleptic malignant syndrome, N Eng J Med 313:163-166, 1985.
- Larach MG for the North American Malignant Hyperthermia Group: Standardization of the caffeine halothane muscle contracture test, Anesth Analg 69:511-515,1989.
- Urwyler A, Censier K, Kaufmann MA, Drewe J: Genetic effects on the variability of the caffeine halothane muscle contracture test, Anesthesiology 80:1287-1295, 1994.
- Wedel DJ, Nelson TE: Malignant hyperthermia: diagnostic dilemma false-negative contracture responses with halothane and caffeine alone, Anesth Analg 78:787-792,1994.
|
|
( MHAUS 1994 )
. , .
, , , :
- , MHAUS
- EtCO2, SaO2
- , 3.000
:
- - 36 /
- 2.000
- 50- 8,4%
- 20% 500
- 4 (40 )
- 50% 50
- 100 /
- 10%
- 50-
- ? 2
- ? 2
- ( )