Malignant temperature gain in anesthesia

The article was written by BSCK II. Nguyen Trung Thanh – Anesthesihetist – Analgesic – Surgical Anesthesio – Share99 Central Park International Health Hub

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Malignant temperature increase is one of the complications after anesthesia, which if not treated in time will lead to death. Who can suffer from this complications, how is the treatment and is preventable?

1. What is malignant temperature gain?

Malignant thermothermia (TTNAT) is a gene disorder associated with the drug and was first described in 1960. The majority of TTNAT reactions occur in children and young people and men prevail over females by a ratio of 2:1. TTNAT has been one of the factors causing anesthesia deaths since the early 20th century.

The main manifestation of this pathology is fever and leads to death if uncontrollable, this syndrome was originally named malignant high fever. It is well known that high temperatures are not thermos conditioning abnormalities but due to excessive heat-creating, this syndrome is renamed malignant temperature increase.

2. Which subjects may have malignant temperature gain in anesthesia?

Malignant temperature increase encountered in patients around the world. In Europe it is estimated that the genetic frequency of TTNAT is 1 in 10,000, which can be 4-5 times higher in French and Italian families. Genetic-related TTNAT corresponds to an incompatious type of dominant chroma.

In Vietnam, there have been a number of reports of TTNAT occurring during anesthesia.

anesthetize

Possible anesthesia with temperature gain

3. Pathology of malignant thermothermia

All clinical manifestations of TTNAT can be explained by an in-clasting of in-sysular Ca2+ concentrations in the sedular muscles. The devastating consequences can be enormous because the sedate muscle accounts for 40% of the body mass. Clinical manifestations become apparent before ca2+ levels increase in muscle cell future.

In the TTNAT response, at first the increase in Ca2+ release is offset by increased calci re-capture (ATP is required). In addition to powering these Ca2+ pumps, ADP degradation ATP has a positive conditioning effect on glucose hydrolysing and oxidation metabolism. The acceleration of the conversion rate results in increased CO2 and oxygen consumption, which leads to cardiovascular and respiratory stimulation.

When the rate of re-arrest of Ca2+ does not keep up with the release of Ca2+, the concentration of in-cell Ca2+ will increase, which leads to the activation of muscle fibers and muscle contraction. The constant cohesion of actin-myosin requires the degradation of ATP that leads to even more stimulation of conversion. This muscle contraction process is also a source of heat (85% of the energy of muscle contraction will turn into heat). Metabolism is also stimulated by the intra-cell ca2+ connection to calmodulin which is a stimulating signaling switch of the glucose hydrolyxation route.

The integrity of the muscle cell membrane is broken by 2 ways. The first is the mechanical consequence of muscle contraction. Muscle fibers are attached to the glycoprotein matrix of the cell membrane by cell frame components. When the muscle fibers contract, the muscle membrane is folded and susceptible to the effects of the force that causes the breakage.

While the muscle works, the permeability of the muscle membrane increases at first only with small molecules such as potassium, but with increased activity, permeability increases with large molecules such as creatine kinase and myoglobine. This increase in permeability may be heavier due to the stimulation of Ca2+ dependent phospholipase; this substance attacks the phospholipide layer of the cell membrane. Sedular lysis is a prominent clinical manifestation of TTNAT that leads to hyperkalemia (arrhythmias) and kidney disease caused by myoglobine (emergency renal failure).

Increasing heat increases the activation activity even more and as the temperature rises it affects all tissues. This further increases oxygen consumption, produces more CO2 and blood acidity with increased sympathetic stimulation and respiratory cardiovascular stimulation. The pressure on the cardiovascular system is even greater due to peripheral dilators and sweating in response to increased body temperature. The sensitivity of muscle fibers also depends on the temperature and as the temperature rises, muscle contraction also increases and aggravates the disis of the muscles.

Another consequence of temperature gain is endometrial activation. Endomester activation stimulates the pre-coabola route that leads to pervasive invascular coaalysis, with the consequence followed by an irritated anti-coalinic path that causes clinical coaulation disorders.

malignant temperature gain causes blood clot disturbances

Increased body temperature can cause clinical blood clot disturbances

4. Can malignant temperature increase reactions be treatable?

In terms of clinical forecasting, non-therapeutic TTNAT will reach an i non-recovery stage. There are two main factors that determine the ability of the TTNAT response to recover: the ability of muscle cells to generate ATP and the maintenance of sufficient blood supply to the damaged muscle. Therefore, it is important to diagnose TTNAT as soon as possible if it wants successful treatment.

Dantrolene is the only drug to date that can treat TTNAT due to the effect of reducing the release of Ca2+ in sysular muscle cells into the intthinal sagging mesh system, which can reverse the TTNAT reaction.

In addition, it is necessary to combine other positive resuscitation treatments to have a chance of survival.

5.Is TTNAT preventable during anesthesia?

TTNAT is heredity-related and is initiated by certain medications used in anesthesia. Therefore, the patient needs to inform the anesthesisithesiy anyone who has ever had TTNAT in anesthesia, abnormalities or complications in surgical anesthesia that the patient or family member has experienced before so that the anesthesi has a plan to choose the appropriate inality method and anesthesia.

Surgical anesthesia is very important and requires high accuracy, the team of doctors needs to have good professional qualifications to ensure effective handling of complications after anesthesia. It is recommended to perform surgery at a reputable medical facility to avoid risk. Share99 International Health Hub is a reputable medical facility, with a team of experienced doctors, high professional qualifications, high education and high degree in the industry. Here, not only gather a team of famous doctors in the country but also international doctors, bringing the new and most effective treatment regimens today.

Modern medical equipment system, fully equipped facilities, facilities, clean environment, meeting the strict requirements of the Ministry of Health to help patients feel secure when treating. To register for examination and treatment at Share99 International Health Hub, you can contact the Hotline of Share99 Health System nationwide, or register for an online examination HERE.

SEE MORE:

  • Malignant temperature gain: Recognition and treatment
  • The relationship between temperature gain and health
  • Heat stroke, heat stroke: Causes and handling

About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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