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KMID : 0604020090240020092
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Korean Journal of Critical Care Medicine
2009 Volume.24 No. 2 p.92 ~ p.98
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Dantrolene and Post-operative Hyperthermia
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Koo Ja-Kyung
Kim Cheol-Hong
Hyun In-Gyu
Yoo Je-Hyun
Park Ji-Young
Lim Ah-Leum
Kwon Se-Ah
Lee Soon-Jae
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Abstract
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Malignant hyperthermia is a rare, fatal pharmacogenetic disorder that occurs during general anesthesia following exposure to a depolarizing muscle relaxant, such as succinylcholine, or volatile anesthetics. Clinical findings in malignant hyperthermia include muscle rigidity, sinus tachycardia, increased CO2 production, skin cyanosis with mottling, and marked hyperthermia. For treatment, cooling techniques must be accompanied by discontinuation of the provocative medication. Furthermore, dantrolene administration is the mainstay of treatment for malignant hyperthermia, and should be initiated as soon as the diagnosis is suspected. We recently experienced a case with post-operative fever of 41.0℃ refractory to conventional anti-pyretic measures and finally resolved with dantrolene administration, in a patient with methicillin-sensitive Staphylococcus aureus monoarthritis of the knee and rapid progression of diffuse septic pneumonia requiring mechanical ventilation.
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KEYWORD
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arthritis, dantrolene, malignant hyperthermia, pneumonia
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