The Nurse`s Role in Treatment of Malignant Hyperthermia Caused by Anaesthetic drugs
Bir, Lovely (2024)
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-2025060921564
https://urn.fi/URN:NBN:fi:amk-2025060921564
Tiivistelmä
Background: Malignant hyperthermia (MH) is defined as a progressive life-threatening hypermetabolic reaction triggered by particular anaesthetic drugs. The underlying mechanism of MH is the dysfunction of the calcium channels in the skeletal muscle cells, which involve some genetic mutations. Patients containing special genetic features like RYR1, CACNA1S, or STAC3 mutation have the possibility of encountering the MH episode when they are exposed to some inhalation and muscle relaxant anaesthetic drugs. Therefore, MH is an inherited autosomal dominant disorder and needs to be diagnosed by identifying the presence of genetic mutation.
Methods: This study aims to figure out the challenges and complications related to MH management from a nursing perspective by conducting an inductive method of data analysis. There are insufficient sources of primary studies related to MH; therefore, a scoping review has been conducted to map the concept of MH and identify the research gaps.
Result: Through reviewing the selected articles, the identified clinical symptoms of MH are divided into two different types- early signs and late signs. The symptoms can be development any time after the patient exposed to the triggering agent. Early detection and prompt treatment are crucial to ensure the success rate of MH management. The diagnosis of MH is based on clinical symptoms of hypercapnia, tachycardia, muscle rigidity, hyperthermia, cardiac arrhythmias and laboratory results. Management of MH includes stopping the trigger, administering dantrolene, correcting tachycardia and electrolyte imbalances, and controlling temperature. Studies have been conducted to illustrate the concept of MH, its clinical features, related medical complications, and possible treatments to avoid fatal complications of MH. Recommendations of MH include pre-assessment of MH susceptibility, collecting family history, conducting genetic testing, reconsideration of anaesthetic drugs, monitoring temperature and other vitals during surgery, assessment of appearing symptoms critically, and available guidelines of MH management among health professionals.
Conclusion: This study provides a clear outline of malignant hyperthermia and the existing guidelines and recommendations for healthcare professionals. This study confirms that the morbidity and mortality rate of MH is still high despite the use of dantrolene and established guidelines. Instead of constant research, the impact of regional environmental differences on MH, the unknown gene mutation, and unpredictable clinical manifestation still needs to be elucidated.
Methods: This study aims to figure out the challenges and complications related to MH management from a nursing perspective by conducting an inductive method of data analysis. There are insufficient sources of primary studies related to MH; therefore, a scoping review has been conducted to map the concept of MH and identify the research gaps.
Result: Through reviewing the selected articles, the identified clinical symptoms of MH are divided into two different types- early signs and late signs. The symptoms can be development any time after the patient exposed to the triggering agent. Early detection and prompt treatment are crucial to ensure the success rate of MH management. The diagnosis of MH is based on clinical symptoms of hypercapnia, tachycardia, muscle rigidity, hyperthermia, cardiac arrhythmias and laboratory results. Management of MH includes stopping the trigger, administering dantrolene, correcting tachycardia and electrolyte imbalances, and controlling temperature. Studies have been conducted to illustrate the concept of MH, its clinical features, related medical complications, and possible treatments to avoid fatal complications of MH. Recommendations of MH include pre-assessment of MH susceptibility, collecting family history, conducting genetic testing, reconsideration of anaesthetic drugs, monitoring temperature and other vitals during surgery, assessment of appearing symptoms critically, and available guidelines of MH management among health professionals.
Conclusion: This study provides a clear outline of malignant hyperthermia and the existing guidelines and recommendations for healthcare professionals. This study confirms that the morbidity and mortality rate of MH is still high despite the use of dantrolene and established guidelines. Instead of constant research, the impact of regional environmental differences on MH, the unknown gene mutation, and unpredictable clinical manifestation still needs to be elucidated.