Anest. intenziv. Med. 2025;36(2):74-83 | DOI: 10.36290/aim.2025.014

Malignant hyperthermia "up­‑to­‑date practically" - non­‑systematic review articleReview Article

Štěpánková D.^{1, 2, *}, Klincová M.^{1, 2, 3, *}, Schröderová I.^{2, 4}, Bönischová T.^{1, 2, 3}, Tomášková V.^{2, 4}, Havránková N.^{1, 2}, Štourač P.^{1, 2, 3}

¹ Klinika dětské anesteziologie a resuscitace, Fakultní nemocnice Brno a Lékařská fakulta Masarykovy univerzity, Brno

² Akademické centrum pro maligní hypertermii, Lékařská fakulta Masarykovy univerzity, Brno

³ Ústav simulační medicíny Lékařské fakulty Masarykovy univerzity, Brno

⁴ Anesteziologicko­‑resuscitační klinika, Fakultní nemocnice u sv. Anny a Lékařská fakulta Masarykovy univerzity, Brno *Tyto autorky se na manuskriptu podílely stejnou mírou

Malignant hyperthermia (MH) is a rare, hereditary, life-threatening pharmacogenetic disease induced by some commonly used anaesthetics. This review article aims to summarise, from a practical point of view, the news and current recommendations in the field of MH so that the anaesthesiologist-intensivist can easily use them in daily practice. The theoretical introduction is only brief, as it serves to gain an essential awareness of the issue of MH. As a matter of priority, we will look at the most common situations where a doctor may encounter MH. We will focus on the anaesthesiology clinic and the recognition of risk factors. In the operating room, preparation of the anaesthesia workplace for MH-risk patients and the management of the acute MH crisis are crucial. As part of intensive care, we will discuss the continuation of MH crisis therapy, and we will also mention situations when, in the case of unexplained rhabdomyolysis, it is worth considering MH. We will refer to the latest recommendations of the European Malignant Hyperthermia Group (EMHG) and briefly comment on their implementation in our conditions, e.g., recommendations regarding dantrolene availability. We will also not forget the approach to pregnant women at risk of MH. In conclusion, we will outline an outlook that reflects the current developments and future changes in the perspective on the issue of MH and explain why the centralisation of care for patients at risk of MH is so necessary.

Keywords: malignant hyperthermia, in vitro contraction test, next-generation sequencing, ryanodine receptor 1, dantrolene.

Received: December 16, 2024; Revised: March 31, 2025; Accepted: April 9, 2025; Prepublished online: May 28, 2025; Published: June 27, 2025  Show citation