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Presumed Malignant Hyperthermia Treated During Cardiopulmonary Bypass in a Pediatric Patient Undergoing Aortic Valve Replacement

A Case Report

Kuntz, Michael T., MD*; Saab, Amanda D., MD

doi: 10.1213/XAA.0000000000000902
Case Reports
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There are no case reports of malignant hyperthermia in pediatric patients treated on cardiopulmonary bypass (CPB). We report the case of a 10-year-old boy undergoing aortic valve replacement. The patient developed progressive tachycardia and hypercarbia. In addition, EtCO2 and PaCO2 were equal and myoglobinuria was suspected given darkened urine. Numerous dantrolene boluses were given on CPB, and a dantrolene infusion was started. The patient’s base deficit and creatine phosphokinase normalized by postoperative day 2. This case demonstrates the importance of expeditious diagnosis of malignant hyperthermia, and the need for additional dantrolene when treating patients whose blood volume is diluted on CPB.

From the *Department of Anesthesiology, University of Miami, Jackson Memorial Hospital, Miami, Florida

Department of Anesthesiology, Division of Pediatric and Adult Congenital Cardiac Anesthesiology, University of Miami, Jackson Memorial Hospital, Miami, Florida.

Accepted for publication August 24, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Amanda D. Saab, MD, Department of Anesthesiology, Division of Pediatric and Adult Congenital Cardiac Anesthesiology, University of Miami, Jackson Memorial Hospital, 1611 NW 12th Ave, SW 303, Miami, FL 33136. Address e-mail to ASaab@med.miami.edu.

© 2019 International Anesthesia Research Society
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