Malignant Hyperthermia Update

Anesthesiol Clin. 2020 Mar;38(1):165-181. doi: 10.1016/j.anclin.2019.10.010.


Malignant hyperthermia (MH) is a rare but potentially lethal skeletal muscle disorder affecting calcium release channels. It is inherited in a mendelian autosomal dominant pattern with variable penetration. The initial clinical manifestations are of a hypermetabolic state with increased CO2 production, respiratory acidosis, increased temperature, and increased oxygen demands. If diagnosed late, MH progresses to multi-organ system failure and death. Current data suggest that mortality has improved to less than 5%. The gold standard for ruling out MH is the contracture test. Genetic testing is also available. MH-susceptible individuals should be clearly identified for safe administration of future anesthetics.

Keywords: Caffeine-halothane contracture test; Charcoal filters; Dantrolene; MHAUS; Malignant hyperthermia.

Publication types

  • Review

MeSH terms

  • Anesthesia / methods*
  • Humans
  • Malignant Hyperthermia / physiopathology*