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A Review of the Factors Affecting the Incidence of Malignant Hyperthermia in the Greater Kansas City Area

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DOI: 10.4236/abb.2014.55055    4,344 Downloads   5,761 Views   Citations

ABSTRACT

Malignant Hyperthermia (MH) is a rare genetic disease. However, it is devastating when it occurs in a patient. MH is usually triggered by inhalational anesthetics and/or depolarizing muscle relaxants. Public awareness of MH has increased with the presentation of an episode on the television program, “House”, and the availability of web-based information. For over 20 years, the MH susceptible pig has been used in experiments by our group as an animal model for MH in humans. The incidence of Malignant Hyperthermia in the Greater Kansas City Area has declined dramatically since the introduction of Sevoflurane in 1992 as the anesthetic of choice (over 60% usage rate) in most surgical procedures. Historically, Malignant Hyperthermia was reported to occur at a rate of 1:50,000 during surgical procedures [1]. In the Greater Kansas City Area, Malignant Hyperthermia (MH) occurred at a rate of 1:53,636 during the 1965-1985 time period, as there were 38 MH cases in 35 patients [2]. During the past ten years (1996-2006), there were only 2 cases of MH, representing an incidence rate of 1:597,240. That decrease is an 11.13 fold (or 89%) decrease which is very significant. Despite the reduced incidence of Malignant Hyperthermia, two recent cases of MH that result in deaths in Wisconsin and Florida make it imperative that MH is recognized early and appropriate treatment initiated without delay. We have expanded our analysis of the futile cycle mechanism that underlies the MH syndrome. MH is equivalent to the rapid discharge of a battery by a short circuit.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Williams, C. , Hoech, G. and Zukaitis, M. (2014) A Review of the Factors Affecting the Incidence of Malignant Hyperthermia in the Greater Kansas City Area. Advances in Bioscience and Biotechnology, 5, 452-461. doi: 10.4236/abb.2014.55055.

References

[1] Williams, C.H. (2014) Malignant Hyperthermia: A Runaway Thermogenic Futile Cycle at the Sodium Channel Level. Advances Bioscience Biotechnology, 5, 197-200.
http://dx.doi.org/10.4236/abb.2014.53025
[2] Britt, B.A. (1987) A History of Malignant Hyperthermia. In: Malignant, H., Ed., BA Britt, Martinus Nijhoff Publishing, Boston, xi-xxii.
[3] Zukaitis, M.G., Hoech, Jr., G.P. and Robinson, J.D. (1986) Malignant Hyperthermia—Pre and Post Dantrolene: A Survey of the Greater Kansas City Area from 1965-1985: 15 Sept 1965. January 1986 Meeting of the Rocky Mountain Traumatoligic Society in Aspen,
[4] Wallin, R.F. and Napoli, M.D. (1971) Sevoflurane (Fluro-methyl-1,1,1,3,3,3,-hexafluro-2-propyl ether) a New Inhalational Agent. Fed Proceed, 30, 442.
[5] Williams, C.H., et al. (1989) Cardiac Performance and Hemodynamics in Malignant Hyperthermia Susceptible and Normal Pigs during Sevoflurane Anesthesia. Attachment #1.
[6] Williams, C.H., Stovall, R.M., Dozier, S.E., Watts, M.T., Bayless, P.A., Marvasti, M.A., Farias, M., Ekery, D.D., Daley, I.W. and Satoh, N. (1988) Cardiac Performance and Hemodynamics in Malignant Hyperthermia Susceptible and Normal Pigs during Sevoflurane Anesthesia. Poster Presentation at the New York State Society of Anesthesiologists Meeting, Hilton, New York City, 10 December 1989,
[7] Watts, M.T., Escarzaga, M. and Williams, C.H. (1992) GTas-Chromatographic Headspace Analysis of Sevoflurane. Journal of Chromatography B: Biomedical Sciences and Applications, 577, 289-298.
http://dx.doi.org/10.1016/0378-4347(92)80250-T
[8] Abbott Laboratories v. Baxter International Inc. (2002) WL 467147 (N.D.Ill. 2002).
[9] Kharasch, E.D. (2007) Sevoflurane: The Challenges of Safe Formulation. APSF Newsletter Fall, 22, 48.
[10] Rosenberg, H. and Rothstein, A. (2006) Malignant Hyperthermia Death Holds Many Lessons. APSF Newsletter: Summer, 21, 32-34.
[11] Williams, C.H., et al. (1977) Proceedings of the Focus on Malignant Hyperthermia Symposium, Wausau, 13 September, 3 Chapters. EO Henschel, Appleton Century Crofts, New York.
[12] Hoech, Jr., G.P., Roberts, J.T., Williams, C.H., Waldman, S.D., Simpson, S.T. and Trim, C.M. (1980) Prevention of Porcine Malignant Hyperthermia with Metocurine. In: Thermoregulatory Mechanisms and Their Therapeutic Implications. 4th International Symposium Pharmacology of Thermoregulation, Oxford, 137-141, Karger:Basel.
[13] Buzello, W., Williams, C.H., Chandra, P., Watkins, M.L. and Dozier, S.E. (1985) Vecuronium and Porcine Malignant Hyperthermia. Anesthesia & Analgesia, 64, 575-279.
http://dx.doi.org/10.1213/00000539-198505000-00012
[14] Williams, C.H., Dozier, S.E., Ilias, W.K. and Fulfer, R.T. (1985) Porcine Malignant Hyperthermia: Testing of Atracurium in MH Susceptible Pigs. Anesthesia & Analgesia, 64, 112.
[15] Williams, C.H., Chandra, P., Serda, R. and Martinez, M. (1992) Malignant Hyperthermia Induction in Susceptible Swine Following Exposure to Organon 9426. Abstracts S350. Anesthesia & Analgesia, 74, S1-S365.
[16] (2006) MHAUS AMRA Report Version 9.1.
[17] (2008) Milwaukee Journal Sentinel: JS Online: Only 20, Athlete Had Zest for Life (Steven Nook). By Amy Rabideau Silvers.
[18] Stephanie Kuleba, Case # 080366, Palm Beach Medical Examiner’s Office.
[19] (2008) The Informed Patient: A Fresh Focus on a Rare Risk of Anesthesia. The Wall Street Journal: 4/30/2008, Laura Landro.
[20] Medical Examiner’s Office (2008) West Palm Beach, Stephanie J. Kulebea, Case # 080366:21 May 2008.
[21] (2008) Making Everlasting Memories, Worldwide Memoralization—Stephanie Jude Kuleba: Guest Book: 10/24/2008.
[22] Williams, C.H., Houchins, C. and Shanklin, M.D. (1975) Energy Metabolism in Pigs Susceptible to the Fulminant Hyperthermia-Stress Syndrome. British Medical Journal, 3, 411-413, Errata 604.
[23] Cark, M.G., Williams, C.H., Pfeifer, W.F., Bloxham, D.P., Holland, P.C., Taylor, C.A. and Lardy, H.A. (1973) Accelerated Substrate Cycling of Fructose-6-Phosphate in the Muscle of Malignant Hyperthermic Pigs. Nature, 245, 99-101.
http://dx.doi.org/10.1038/245099a0
[24] Williams, C.H. (1974) The Development of an Animal Model for the Fulminant Hyperthermia-Porcine Stress Syndrome. Proceedings of the Focus on Malignant Hyperthermia Symposium, Wausau, 13 September 1974, 117-140.
[25] Williams, C.H., et al. (1977) The Fulminant Hyperthermia-Stress Syndrome: Genetic Aspects, Hemodynamic and Metabolic Measurements in Susceptible and Normal Pigs. Proceedings of 2nd International Symposium on Malignant Hyperthermia, Denver, 1-3 April 1977, 161-173.
[26] Williams, C.H., Farias, M., Marvasti, M.A., Knight, A.B., Ekery, D.D., Daley, I.W. and Zayed, I. (1990) Malignant Hyperthermia Induction in Susceptible Swine Following Exposure to Arduan. Anesthesia & Analgesia, 70, S433.
http://dx.doi.org/10.1213/00000539-199002001-00433
[27] Williams, C.H., et al. (1986) Metabolic Rate in Malignant Hyperthermia Pigs. In: Swine in Biomedical Research, Vol. 1, Ed., ME Tumbleson, Plenum, New York, 573-582.
[28] Williams, C.H. (1988) Experimental Malignant Hyperthermia. Springer Verlag, New York.
[29] Steiss, J.E., Bowen, J.M. and Williams, C.H. (1981) Electromyographic Evaluation of Malignant Hypermia Susceptible Pigs. American Journal of Veterinary Research, 42, 1175-1178.

  
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