TITLE:
A Review of the Factors Affecting the Incidence of Malignant Hyperthermia in the Greater Kansas City Area
AUTHORS:
Charles H. Williams, George P. Hoech, Mark G. Zukaitis
KEYWORDS:
Sevoflurane; Malignant Hyperthermia
JOURNAL NAME:
Advances in Bioscience and Biotechnology,
Vol.5 No.5,
April
2,
2014
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.