Anaes SAQs · Malignant hyperthermia
Recognising and managing the malignant hyperthermia crisis
The canonical MH SAQ — the sentinel ETCO2 (not the fever), the crisis bundle (stop triggers, hyperventilate, dantrolene, cool, treat hyperkalaemia), and the discipline of giving dantrolene early. Built on the EMHG 2024 and MHAUS guidelines.
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Prompt
Twenty minutes after induction of anaesthesia with sevoflurane for an elective procedure, the end-tidal carbon dioxide rises to 8 kPa despite an unchanged minute volume, the heart rate climbs, and the patient is becoming hot. Outline your diagnosis and immediate management.
Question
Twenty minutes after induction of anaesthesia with sevoflurane for an elective procedure, the end-tidal carbon dioxide rises to 8 kPa despite an unchanged minute volume, the heart rate climbs, and the patient is becoming hot. Outline your diagnosis and immediate management.[9]
References4ShowHide
- [8]Glahn KPE, Girard T, Hellblom A, et al. Recognition and management of a malignant hyperthermia crisis: updated 2024 guideline from the European Malignant Hyperthermia Group. British Journal of Anaesthesia, 2025.PMID 39482150
- [2]Larach MG, Gronert GA, Allen GC, Brandom BW, Lehman EB. Clinical presentation, treatment, and complications of malignant hyperthermia in North America from 1987 to 2006. Anesthesia & Analgesia, 2010.PMID 20081135
- [7]Litman RS, Smith VI, Larach MG, et al. Consensus Statement of the MHAUS on Unresolved Clinical Questions Concerning the Management of Patients With Malignant Hyperthermia. Anesthesia & Analgesia, 2019.PMID 30768455
- [9]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.