Document Detail


The relationship between exertional heat illness, exertional rhabdomyolysis, and malignant hyperthermia.
MedLine Citation:
PMID:  19617585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exertional heat illness, exertional rhabdomyolysis, and malignant hyperthermia (MH) are complex syndromes with similar pathophysiology. All three are hypermetabolic states that include high demand for adenosine triphosphate, accelerated oxidative, chemical, and mechanical stress of muscle, and uncontrolled increase in intracellular calcium. Although there are no controlled clinical studies to support a relationship, there is evidence to suggest an association between unexpected heat/exercise intolerance and MH susceptibility. There are multiple case reports and a small number of clinical studies that have used in vitro muscle contracture testing and/or genetic testing to make the association. However, such methodology is problematic in that these tests are validated for clinical MH in association with anesthesia, and not for exertional heat illness or exertional rhabdomyolysis. Nevertheless, these relationships may have implications for some MH-susceptible patients and their capacity to exercise, as well as for clinicians treating and anesthetizing patients with histories of unexplained exertional heat and exercise illnesses.
Authors:
John F Capacchione; Sheila M Muldoon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-07-17
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  109     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-18     Completed Date:  2009-10-01     Revised Date:  2010-04-02    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1065-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA. jcapacchione@usuhs.mil
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MeSH Terms
Descriptor/Qualifier:
Anesthesia / adverse effects*
Evidence-Based Medicine
Exercise Tolerance
Heat Stress Disorders / complications*
Humans
Malignant Hyperthermia / diagnosis,  etiology*
Physical Exertion*
Practice Guidelines as Topic
Rhabdomyolysis / complications*
Risk Assessment
Risk Factors
Comments/Corrections
Comment In:
Anesth Analg. 2010 Apr;110(4):1241; author reply 1241   [PMID:  20357163 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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