Kenneth Kee

Abnormal High Fever (Malignant Hyperthermia), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions (eBook, ePUB)

• Format: ePub

Produktbeschreibung

This book describes Abnormal High Fever, Diagnosis and Treatment and Related Diseases
Malignant hyperthermia (or abnormal high fever) is an genetic disorder that produces a rapid increase in body temperature (fever) and severe muscle contractions (myalgia) when the affected person is provides with general anesthesia.
This disorder is not the same as hyperthermia due to medical emergencies such as heat stroke.
This is a rapid rise in temperature normally activated by an anesthetic and tends to be lethal
It is an inherited myopathy caused by a genetic mutation.
Linkage studies reveal that in the majority of families the defect is in the ryanodine receptor gene (RYR1) at chromosome 19q13.1
Malignant hyperthermia is an autosomal dominant trait, indicating it needs only one parent carrying the disorder for a child to inherit the disorder.
It may be linked with muscular diseases such as multi-mini-core myopathy and central core disease.
A form of malignant hyperthermia is produced by a defect in the ryanodine receptor (RYR1) gene
Malignant hyperthermia (MH) reactions happen with the onset postponed for several hours into anesthesia using:
1. Halothane especially,
2. Desflurane,
4. Sevoflurane, and
5. Isoflurane
It has been limked with:
1. Myotonia congenita
2. Duchenne muscular dystrophy and
3. Becker's muscular dystrophy.
Non-depolarizing neuromuscular blockers such as pancuronium are harmless.
Nitrous oxide and barbiturates such as thiopental are safe.
Symptoms are:
1. Rapid rise in temperature to 105 degrees F or higher
2. Muscle rigidity and stiffness
3. Dark brown urine (myoglobulin)
4. Muscle ache without obvious exercise to explain sore muscles
Onset may be during or within a few hours after anesthesia.
Spasm of the masseter muscle is often first noted.
There is muscular rigidity despite a paralyzing agent
There is tachycardia and the skin is flushed.
There is hypoxia, hyper-capnea and a metabolic acidosis.
Temperature may rise above 40° but normo-thermia does not exclude the condition.
Diagnosis:
There can be a family history of malignant hyperthermia or non-explained death during anesthesia.
Genetic testing is used to institute a diagnosis, but the caffeine halothane contracture test (CHCT) is the criterion standard.
Diagnosis is made by the muscle biopsy.
Caffeine, halothane, succinylcholine and raised potassium induce amplified contractions.
DNA testing cannot be used as the only test for MH susceptibility
Treatment
For an episode of malignant hyperthermia, a cooling blanket can help reduce fever.
The treatment with a drug called dantrolene throughout events of malignant hyperthermia has largely decreased the number of deaths.
Dantrolene, the antidote, decreases the loss of calcium from the sarcoplasmic reticulum in the skeletal muscle and restores normal metabolism
Fluids given orally and intravenously, and certain medicines, are important for maintaining the kidney function during an acute episode.
1.Call for help, as management can be difficult and complex for one person.
2.Switch from volatile anesthetics to alternative forms of anesthesia.
3.Give 100% oxygen and adjust ventilation according to blood gas analysis and end expiratory pCO2.
4.Deepen anesthesia with opioids, benzodiazepines, barbiturates or propofol.
5.Monitor blood gases, electrolytes, CK, myoglobin and lactate.
6.Stop surgery if it is elective and if there are signs of masseter spasm or a fulminant crisis.
7.Continue surgery, if there is no hyper-kalemia, no acidosis and there are no triggers.
8.Intravenous dantrolene should be given but prophylactic administration of dantrolene is now regarded as obsolete.
9.Arrhythmia may be treated with a beta-blocker or lidocaine.
TABLE OF CONTENT
Introduction
Chapter 1 Abnormal High Fever
Chap...

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Produktdetails

• Verlag: Kenneth Kee
• Erscheinungstermin: 9. November 2017
• Englisch
• ISBN-13: 9781370789993
• Artikelnr.: 49926470

Autorenporträt

Dr. Kenneth Kee is a well-known medical doctor from Singapore who has been practicing medicine since 1972.
He graduated from the University of Singapore and furthered his studies with a Master of Science in Health Management in 1991, followed by a Ph.D. in Healthcare Administration in 1993.
Dr. Kee established Kee Clinic in 1974, located in the Holland Drive area of Singapore. The clinic has been a prominent feature of the community, offering general medical services for 5 decades.
Dr Kee also served his country Singapore as a national service police Inspector at night from 1975 to 1985 while working at his clinic during the day.
He had served as a police guard to the Woodland Petroleum Tanks at night during the Indonesian Confrontation period, took part in police rounds at night in the Beach Road area and taught First aid and emergency resuscitation to Police recruits.
He received the Singapore Police Bicentennial 2020 Medallion on 1st March 2024 as recognition for his work in the Singapore Police.
Even as he grew older, Dr. Kee continued to work actively in his clinic, although he eventually reduced his consultation hours.
Beyond his medical career, Dr. Kee is also an author.
He started writing about medical conditions in 2007, using blogs and other online platforms to share his knowledge with a broader audience.
Over time, he published various books, many of which provide simple and accessible guides to different health conditions.
His works include "A Family Doctor's Tale," "My Personal Singapore History," and numerous medical guides, available through platforms like Amazon.
His books often combine his personal experiences as a family doctor with insights into Singapore's healthcare system and history.
Dr. Kee has written extensively on health topics, contributing to both medical literature and general knowledge resources.

Dr. Kenneth Kee has written numerous books, primarily focused on health education and personal experiences as a family doctor. Some of his notable titles include:
"A Family Doctor's Tale"
This book is a blend of Dr. Kee's personal experiences and his reflections on being a family doctor in Singapore. It's a great choice if you're looking for a narrative that combines both medical knowledge and human stories.
"Specialized Medical Conditions"
Books like **"Congestive Heart Failure: Diagnosis and Treatment"** focus on specific conditions, offering in-dept...