Availability of dantrolene for the management of malignant hyperthermia crises: European Malignant Hyperthermia Group guidelines.
- Glahn KPE Danish Malignant Hyperthermia Centre, Department of Anaesthesia, Herlev University Hospital, Copenhagen, Denmark. Electronic address: klaus.glahn@regionh.dk.
- Bendixen D Danish Malignant Hyperthermia Centre, Department of Anaesthesia, Herlev University Hospital, Copenhagen, Denmark.
- Girard T Department of Anaesthesioloy, University Hospital Basel and University of Basel, Basel, Switzerland.
- Hopkins PM Malignant Hyperthermia Unit, St James's University Hospital, Leeds, UK. Electronic address: p.m.hopkins@leeds.ac.uk.
- Johannsen S Department of Anaesthesia and Critical Care, University of Wuerzburg, Wuerzburg, Germany.
- Rüffert H Klinik für Anästhesie, Intensivmedizin, Schmerztherapie, Helios Klinik Schkeuditz, Leipzig-Schkeuditz, Germany; Department of Anaesthesiology and Intensive Care Medicine, MH Center University Hospital Leipzig, Leipzig, Germany.
- Snoeck MM Department of Anaesthesiology, Canisius-Wilhelmina Ziekenhuis, Nijmegen, Netherlands.
- Urwyler A Department of Anaesthesioloy, University Hospital Basel and University of Basel, Basel, Switzerland.
- 2020-06-28
Published in:
- British journal of anaesthesia. - 2020
European Malignant Hyperthermia Group
dantrolene
guidelines
malignant hyperthermia
safety
succinylcholine
volatile anaesthetics
Anesthesia Department, Hospital
Dantrolene
Drug Storage
Emergencies
Emergency Medical Services
Europe
Humans
Malignant Hyperthermia
Muscle Relaxants, Central
English
Faced with a malignant hyperthermia crisis, the immediate access to sufficient dantrolene is essential to achieve the best possible outcome for the patient. However, malignant hyperthermia crises are rare, and there may be administrative pressures to limit the amount of dantrolene stocked or, in some countries, not to stock dantrolene at all. There are no published guidelines to support anaesthetic departments in their effort to ensure availability of sufficient dantrolene for the management of malignant hyperthermia crises. After a literature review that confirmed a lack of clinical trials to inform this guideline, we undertook a formal consensus development process, in which 25 members of the European Malignant Hyperthermia Group participated. The consensus process used a modified web-based Delphi exercise, in which participants rated the appropriateness of statements that covered the dosing regimen for dantrolene in a malignant hyperthermia crisis, the types of facility that should stock dantrolene, and the amount of dantrolene that should be stocked. The resulting guidelines are based on available evidence and the opinions of international malignant hyperthermia experts representing a large group of malignant hyperthermia laboratories from around the world. Key recommendations include: the dosing regimen of dantrolene should be based on actual body weight, dantrolene should be available wherever volatile anaesthetics or succinylcholine are used, and 36 vials of dantrolene should be immediately available with a further 24 vials available within 1 h.
- Language
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- English
- Open access status
- bronze
- Identifiers
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- DOI 10.1016/j.bja.2020.04.089
- PMID 32591088
- Persistent URL
- https://sonar.ch/global/documents/150440
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