With the marked improvement in monitoring during anesthesia, early diagnosis of a malignant hyperthermia crisis now occurs with a dramatic fall in mortality. The signs of malignant hyperthermia can be divided into two groups: metabolic stimulation and muscle abnormality. Malignant hyperthermia is often described as a metabolic storm with increased CO2 production, falling SaO2, increased heart rate, often with dysrhythmias, increased core temperature, and metabolic acidosis. The signs associated with muscle involvement include masseter muscle spasm, generalized rigidity, marked rise in creatine kinase, myoglobinuria, and a rise in serum K +.
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