Resumen

HERNANDEZ ORTEGA, Rudy et al. Severe hyperthermia present after a heart surgery. Rev cuba anestesiol reanim [online]. 2011, vol.10, n.2, pp. 158-164. ISSN 1726-6718.

Introduction: Malignant hyperthermia is a hereditary myopathy caused by a rianodine receptor disorder of rugous sarcoplasmic reticulum of the skeletal muscle becomes clear in patients oversensitive to exposition to halogen agents or to succinylcholine. Objective: To present the course of patient presenting with a severe hyperpyrexia after a heart surgery. Clinical case: Patient aged 56 programmed for an aortic valvular replacement, ASA III, functional class NYHA-II-III without other backgrounds. At her arrival to Postperative Intensive Care Unit (POICU) it was noted a significant widespread muscular contracture mainly in masseter muscles, a progressive increase of the arterial CO2 (105 mm Hg), metabolic acidosis, low paO2/FiO2 relations, urine of red wine color, hyperpotassemia, sinus tachycardia with frequent early ventricular contractions, self-limited of ventricular tachycardia, a sever and low cardiac output and sustained hyperpyrexia if 41°C taking measures related to symptoms. At 8 hours fever decreased with restoration of internal environment, urine color cleared, hemodynamics was stable verifying a rise of serum creatinine which decreased progressively after few days. At 48 hours patient was weaned of the mechanical ventilation. At 5 days she was discharged from the POICU. Conclusions: Apart from there were not specific tests to malignant hyperthermia, it is a complex case presenting with a severe hyperpyrexia and a satisfactory course.

Palabras clave : Malignant hyperthermia; halogen agents; hereditary myopathy; masseter muscles; dantrolen.

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