Malignant Hyperthermia in Children, Contemporary Diagnostic Possibilities in the Czech
Republic
Štěpánková D., Dominik P., Klimovič M., Schröderová I.1, Valášková I.2
ARO a ECMO centrum FN Brno, pracoviště Dětská nemocnice přednosta prim. MUDr. M. Klimovič ARK, FN u sv. Anny, Brno1 přednosta prof. MUDr. P. Ševčík, CSc. OLG FN Brno, pracoviště Dětská nemocnice2 prim. MUDr. R. Gaillyová |
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Summary:
Malignant hyperthermia (MH) is a serious complication of general anaesthesia, the risk of its development
cannot be completely eliminated in common anaesthesiological practice. The incidence is higher in children than
in adults - 1:10 000 anaesthesias. It is an uncontrolled hypermetabolic reaction caused by the presence of triggers
(most frequently volatile anaesthetics and the depolarizing relaxant suxamethonium). Basically an autosomal
dominant (AD) disorder of the calcium metabolism of the muscle cell is involved in the regulation of which the
main part is played by the ryanodine receptor RYR1 of the sarcoplasmic reticulum (SR). The diagnosis of MH
disposition in man is based on a positive result of themuscular contraction test in vitro (IVCT) or evidence of some
of the 25 so far known mutations in the RYR1 gene. Susceptible subjects can be easily detected by through and
aimed preoperative examination as well as within the framework of the usual routine. In risk subjects anaesthesia
must be implemented without triggers (or after special preparation), ensured by adequate monitoring and
perioperative intensive care, subsequently by definite confirmation or ruling out ofMHsensitivity. Comprehensive
diagnosis is from this year available also in the Czech republic.
The purpose of the present paper is to make paediatricians familiar with the problem of malignant hyperthermia
as data in postgraduate literature are very scarce and new findings are rapidly accumulating: to inform on
the existence of a „Database of families with the risk ofMH“, the foundation and activities of the National Centre
for the Diagnosis of Malignant Hyperthermia in Brno.
Key words:
malignant hyperthermia, preoperative examination, risk factors, database of families at risk of
MH, availability of diagnosis in CR
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