Malignant hyperthermia
Sharon Ann Van WicklinPurpose:
To review the pathophysiology, risk factors, clinical manifestations, and management of malignant hyperthermia (MH) while emphasizing the importance of facility preparedness, interprofessional collaboration, competency validation, simulation-based training, and quality improvement across the surgical continuum.
Materials and methods:
Current literature and guidance from the
Results:
MH is a rare but potentially fatal pharmacogenetic disorder characterized by a hypermetabolic response to triggering anesthetic agents. Although advances in monitoring, treatment, and education have reduced mortality, successful outcomes continue to depend on early recognition and immediate intervention. Effective management requires prompt discontinuation of triggering agents, administration of dantrolene sodium, aggressive supportive care, and coordinated interprofessional teamwork. Because MH is a low-frequency, high-acuity event, preparedness efforts should include readily accessible emergency medications and equipment, anesthesia machine preparation protocols, simulation-based training, competency validation, mock drills, and ongoing evaluation of organizational readiness.
Conclusions:
Despite its rarity, MH remains a significant perioperative patient safety concern. Ongoing professional education, competency assessment, interdisciplinary collaboration, and quality improvement initiatives are essential to maintaining preparedness and supporting timely, effective management when an MH crisis occurs.