Malignant Hyperthermia

The clinical ECG findings of hypothermia include reversible and temperature-dependent abnormalities: morphology (Osborn waves), rhythm (bradycardia, premature atrial and/or ventricular beats, atrial fibrillation, VT/VF), time (prolonged PR, QRS, and QT intervals ) and conduction (AV-block)[14, 15].

Futterman LG, Lemberg L. The Significance of Hypothermia in Preserving Ischemic Myocardium. Amer J Crit Care 13: 79-84, 2004. Web. 29 June 2015.

Malignant Hyperthermia is a life-threatening, genetic disorder that involves the skeletal muscles. It commonly occurs intraoperatively and postoperatively when inhalant agents such as halothane, enflurane, and isoflurane are used, as well as some muscle relaxants such as succinylcholine and curare. It

hypertension. Therapeutic hypothermia (THT) has been considered an effective method for reducing ischemic injury of the brain due to cardiac arrest. But there are some opponents in the medical community who believe that broadening the scope of THT could be dangerous to patients. Although opponents do not seem to blame THT for adverse patient outcomes; the disagreement seems to be about the variables involved before hospital arrival, amount of time that it takes to administer THT in the ER, which therapies should be administered with THT and the need for more research that tracks adverse events. A study published by The American Journal of Emergency Medicine supports the widely held view that THT is an effective treatment for cardiac arrest

Therapeutic hypothermia can save lives, as well as maintain neurological proficiency. The risks however are ever-present. The possibility of developing a cardiac arrhythmia is very possible. The fact is however that the majority of cardiac arrhythmias do not present immediate or life threatening dangers. It is possible, yet uncommon, for the arrhythmia to pose serious effects on the circulatory system, and therefore seeing as this is the most common problem that s caused by the use of therapeutic hypothermia, when weighed against the possibility of preserving neurological function and or saving a life, the benefits can potentially often outweigh the risks. Though there are other, more serious problems that can arise due to the use of this treatment, they are far less common, and or

Vasoconstriction- The sympathetic nervous system on the brain causes the heart rate to increase making your veins constrict. This is called vasoconstriction and the blood flow will be directed right to the muscle to help it work harder. Temperature increases to help the flow of blood around the body. Your reflexes will be quicker and your muscles tense. This facilitates the blood carrying oxygen and removing waste products.

MH alters the calcium channel in the sarcoplasmic reticulum (SR) and this allows large quantity of calcium to be released from the SR creating hyper-action in skeletal muscle; this reaction increases oxygen consumption and increased heat production that ultimately leads to a hypermetabolic state after the inhaled Halothane has triggered the condition (Knies). The continuous elevation of calcium also causes excessive stimulation of anaerobic glycolytic metabolism. This creates respiratory and metabolic acidosis, rigidity (muscle contractions), and hyperkalemia (elevated potassium) and can ultimately lead to death

Malignant hyperthermia may not show itself during the first surgery. Yet, during future surgeries the risk remains. In some rare occurrences, people with the condition have shown signs of a reaction after intense exercise. The surgeon and anesthesiologist should be notified prior to surgery if the patient has been diagnosed with malignant hyperthermia so that they can be prepared to treat the reaction if it should occur. Treatment consists of a drug called dantrolene (Dantrium). Dantrolene is a skeletal muscle relaxant. It is indicated for the prophylaxis treatment of malignant hyperthermia. It acts directly on skeletal muscle, causing relaxation by decreasing calcium release from sarcoplasmic reticulum in muscle cells. It also prevents the intense catabolic process associated with the condition. The dosage indicated for adults by PO is 4-8 mg/kg/day in 3-4 divided doses for 1-2 days before the procedure, the last dose is to be given 3-4 hours preoperative. The dosage for adults during a post-hyperthermic crisis follow-up is 4-8 mg/kg/day PO in 3-4 divided doses for

The nursing topic that I am going to base my final paper on is the use of hypothermia therapy following the successful resuscitation of adult patients. I want to further understand the positive or the negative outcomes for patients after we have using the hypothermia therapy protocol. hypothermia _1_.pdf This is one of the research studies that I plan on using in the research for my finial paper. The PICO question that I will be trying to answer in my research paper will be " In the resuscitated adult patient does the use of hypothermia therapy have a reduced mortality rate for adult patients after they have been discharged from the hospital?" By using the definition of PICOT from our book, the P in my research is resuscitated adult patients,

Therapeutic hypothermia, also called targeted temperature management, is a procedure that lowers the body's temperature in order to treat a heart that has suddenly stopped working (cardiac arrest). This procedure is used in emergency situations. During cardiac arrest, the brain cannot get enough oxygen. The brain also starts to swell, which can damage or kill brain cells. Therapeutic hypothermia helps reduce swelling in the brain. It also slows down the body's metabolism and allows the heart and brain to recover.

Malignant hypothermia is a disease, caused by a bad reaction of anesthetics. This disease causes an immensely rapid temperature rise and extreme muscle contractions. MH (malignant hypothermia) is passed down through families and inherited by one parent carrying it giving it to the child. “Malignant hyperthermia occurs in 1 in 5,000 to 50,000 instances in which people are given anesthetic gases” (NIH, 2007). Most people aren’t aware that they are prone to this disease/reaction because they have never been under anesthesia drugs, or have never received surgery.

This article is a example of a foundation of knowledge on the topic of therapeutic hypothermia. Gardner & MacDonald discuss that the typical post cardiac arrest patient does not survive or will recover with severe neurologic deficits as a result of ischemic brain injury from lack of blood flow to the brain (2013). The process of brain death is examined as well as the damange that occurs with reperfusion after ROSC. Damage particularly to the cerebral cortex, cerebellum and hypothalamus can leave the patient in a comatose state if revived (Gardner & MacDonald, 2013). This article is particuarlly valuable as it explains on a physiological level how TH protects the brain from reperfusion injury and improves neurologic outcomes and survivability. The article defends that TH is the best practice for preventing further neurologic damage after ROSC and provides a clinical example. The clinical example recounts a case in which a patient suffered an out of hospital cardiac arrest. Upon admission to the ICU the therapeutic hypothermia protocol was initiated and the patient was cooled below 35 degrees celcius for 24 hours. After rewarming the patient regained consciousness and within ten days was discharged from the hospital with normal neurologic function and as a survivor (Gardner & MacDonald,

Hypothermia has two main types of causes. It classically occurs from exposure to extreme cold. Commonly this includes alcohol intoxication but may also include low blood sugar, anorexia, and advanced age. Hypothermia may be diagnosed based on either a person's symptoms in the presence of risk factors or by measuring a person's core temperature. One of the lowest documented body temperatures from which someone with accidental hypothermia has survived is in a near-drowning of a 7-year-old girl in Sweden. Survival after more than six hours of CPR has been described. Symptoms of mild hypothermia may be vague, Increased urine production due to cold, mental confusion, and hepatic dysfunction may also be present. Hyperglycemia may be present, as glucose consumption by cells and insulin secretion both decrease, and tissue sensitivity to insulin may be blunted. Sympathetic activation also releases glucose from the liver. In many cases, however, especially in alcoholic patients, hypoglycemia appears to be a more common presentation. Low body temperature results in shivering becoming more violent. Muscle mis-coordination becomes apparent. Movements are slow and labored, accompanied by a stumbling pace and mild confusion, although the person may appear alert. Surface blood

Muscle tissue is considered as a key heat source in our body as it consumes a large proportion of an individual’s body mass. When skeletal muscle contracts, it utilizes ATP and produced ADP and releases heat energy which helps maintain a constant body temperature. This is noticeable when one exercises, when sustained muscle movement causes body temperature to increase and when the temperature is cold, shivering causes the muscle to contract to generate heat. Approximately two-thirds of the energy utilized in cellular respiration is lost as heat; this heat is circulated throughout the body via blood, hence maintaining thermoregulation and the homeostasis of body temperature.

As told, therapeutic hypothermia is a process which is used by doctors to help reduce damage to patient’s body and brain function after a cardiac arrest, which commonly knows as a stroke. Cardiac arrest can be sudden and deadly to people. Cardiac arrest is often caused by ventricular fibrillation, where patient’s heart experience rapid and sudden impulse. In result, patient’s heart is not beating hard enough and can’t pump enough blood to other organs and result organ failure. Particularly to patient’s brain because it’s the first part of the body suffers, all depends on an uninterrupted supply of blood. Reduced blood flow to your brain causes unconsciousness and for a long term can fatal damage to people. Now we have the way to cure patient