Malignant Hyperthermia in Brazil: Analysis of Hotline Activity in 2009

Abstract

The number of calls per year in the Brazilian hotline service for MH is still low. The characteristics of MH episode were similar to those reported in other countries. The knowledge of MH in Brazil needs to be increased.

Knowledge of nursing professionals of a surgical center regarding malignant hyperthermia

“…The service concluded that the number of calls is still low and it is necessary to increase the knowledge about MH in Brazil. (5) The results of this study showing that health professionals had little knowledge of the subject of MH are in agreement with those presented in other studies (5, 9,-10) , emphasizing the need for training and expanding the knowledge of health professionals to enable them to recognize patients who may present a crisis of MH during the perioperative period.…”

“…(4) In Brazil, there are no current data on the incidence; however, it is estimated that general anesthesia is performed approximately fi ve million times annually, and therefore this number is consistent with the annual incidence of 500 to 1,000 cases of MH in São Paulo alone. (5) Clinical signs that may indicate the onset of MH are: unexplained tachyarrhythmias, which may occur in 96% of cases; tachypnea in 85% of patients; and acidosis in 80% of patients in response to increased gluconeogenesis. An event will also produce abnormal amounts of lactic acid, carbon dioxide (CO 2 ), and heat, as well as sustained contraction of muscle groups, which leads to greater use of available adenosine triphosphate (ATP) and oxygen.…”

Educational intervention on malignant hyperthermia with nursing professionals of the operating room

“…Malignant hyperthermia was first described in 1960 and occurs in a frequency up to 1:10,000 of general anesthesia in children and 1:50,000 of general anesthesia in adults (1) . The first report of malignant hyperthermia in Brazil was published in 1975 during anesthesia with halothane, but there are no data on its real incidence in Brazil (2) . The treatment consists of early recognition of triggering agents, removal of these agents and administration of Dantrolen.…”

“…The treatment consists of early recognition of triggering agents, removal of these agents and administration of Dantrolen. Malignant hyperthermia is an anesthetic emergency and there are protocols with explicit roles for each team member which should be standardized and oriented toward effective care (2) . General anesthesia is a reversible state of unconsciousness that allows patients to undergo surgical procedures in a safe and humane way.…”

“…The morbidity associated with general anesthesia varies from minor complications that affect the patient's experience without long-term consequences to complications that can result in permanent disability (1) . However, mortality related to this procedure is rare, and the few occurrences have significantly decreased over the past five decades (2) . Therefore, knowledge on the part of nurses in the operating room on the pathophysiology, complications and how to treat a malignant hyperthermia crisis is of real importance to be able to perform all the necessary patient care with competence and quality.…”