section name header

Table 23-9

Discontinue triggering agents
Hyperventilation with 100% oxygen
Dantrolene 2.5 mg/kg IV: titrate additional dantrolene to heart rate, temperature, PaCO2
Serial monitoring of arterial blood gases
Correct metabolic acidosis with sodium bicarbonate IV
Control cardiac dysrhythmias
Active cooling
  • Surface ice packs
  • Body cavity lavage
  • Cardiopulmonary bypass in severe cases

Cease active cooling when core temperature reaches 38ºC
Correction of hyperkalemia
  • Glucose, insulin, sodium bicarbonate, hyperventilation
  • Calcium if hyperkalemia causes cardiac dysfunction
Measurement of renal function, liver function and coagulation
After acute episode subsides, monitor for recrudescence of MH, DIC, and myoglobinuria

DIC = disseminated intravascular coagulation; IV = intravenous: MH = malignant hyperthermia.