Malignant hyperthermia in Brazil: analysis of hotline activity in 2009.

Journal: Brazilian Journal Of Anesthesiology (Elsevier)
Published:
Abstract

Objective: Malignant hyperthermia (MH) is a pharmacogenetic disease that causes abnormal hypermetabolic reaction to halogenated anesthetics and/or depolarizing muscle relaxants. In Brazil, there is a hotline telephone service for MH since 1991, available 24 hours a day in São Paulo. This article analyzes the activity of the Brazilian hotline service for MH in 2009.

Methods: Prospective analysis of all phone calls made to the Brazilian hotline service for MH from January to December 2009.

Results: Twenty-two phone calls were received: 21 from the South/Southeast region of Brazil and one from the North region. Fifteen calls were requests for general information about MH. Seven were about suspected MH acute episodes, two of which were not considered as MH. In five episodes compatible with MH, all patients received halogenated volatile anesthetics (2, isoflurane; 3, sevoflurane) and one also used succinylcholine; there were four men and one woman, with a mean age of 18 years (2-27). The problems described in the five MH episodes were tachycardia (5), increased expired carbon dioxide (4), hyperthermia (3), acidemia (1), rhabdomyolysis (1), and myoglobinuria (1). One patient received dantrolene. All five patients with MH episodes were follow-up in the intensive care unit and recovered without sequelae. Susceptibility to MH was later confirmed in two patients by in vitro muscle contracture test.

Conclusions: 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.

Authors
Helga Cristina Da Silva, Clea Dos Almeida, Julio Cézar Brandão, Cleyton Nogueira E Silva, Mariana Elisa De Lorenzo, Carolina Baeta Neves Ferreira, André Resende, Sara Barreira, Priscilla De Almeida, Leonardo Henrique Ferraro, Alexandre Takeda, Kátia De Oliveira, Talitha Lelis, Alexandre Hortense, Marcelo Perez, Beny Schmidt, Acary Souza Oliveira, José Luiz Do Amaral