Exertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation  

作　　者：Karel Heytens Jan De Bleecker Walter Verbrugghe Jonathan Baets Luc Heytens 

机构地区：[1]Department of Anesthesiology, University Hospital Antwerp [2]Department of Neurology, AZ Sint-Lucas [3]Department of Neurology, University Hospital Ghent [4]Department of Intensive Care, University Hospital Antwerp [5]Department of Neurology, University Hospital Antwerp [6]Laboratory of Neurogenetics and Biobank, Institute Born-Bunge, University of Antwerp [7]MH Research Unit, University of Antwerp [8]Departments of Anesthesiology and Neurology, University Hospital Antwerp

出　　处：《World Journal of Critical Care Medicine》2017年第1期21-27,共7页世界重症医学杂志

摘　　要：In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units(ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique. As illustrated by the three case studies we elaborate upon, a thorough diagnostic work-up is needed to clarify the subsequent risk of strenuous exercise, and the anesthetic exposure to volatile agents in these patients and their families. Other contraindications for the use of volatile intensive care sedation consist of known malignant hyperthermia susceptibility, congenital myopathies, Duchenne muscular dystrophy, and intracranial hypertension.In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units(ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique. As illustrated by the three case studies we elaborate upon, a thorough diagnostic work-up is needed to clarify the subsequent risk of strenuous exercise, and the anesthetic exposure to volatile agents in these patients and their families. Other contraindications for the use of volatile intensive care sedation consist of known malignant hyperthermia susceptibility, congenital myopathies, Duchenne muscular dystrophy, and intracranial hypertension.

关 键 词：EXERTIONAL RHABDOMYOLYSIS Heat stroke Intensive care SEDATION INHALATIONAL ANESTHETICS Malignant hyperthermia Congenital MYOPATHIES 

分 类 号：R614[医药卫生—麻醉学]