{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:54:36Z","timestamp":1790042076617,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,6,27]],"date-time":"2016-06-27T00:00:00Z","timestamp":1466985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"departmental resources"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2016,9]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Malignant hyperthermia (MH<\/jats:styled-content>) is a rare anesthetic pharmacogenetic disorder that can be difficult to detect in its earliest phases. Prompt treatment is known to improve outcomes. The modern anesthesia information management systems (AIMS<\/jats:styled-content>) collect enormous amounts of data. However, data lack context and are not able to provide real\u2010time guidance. Utilizing our AIMS<\/jats:styled-content>, we developed the capacity to incorporate decision support.<\/jats:p><\/jats:sec>Aims<\/jats:title>We describe the creation and evaluation of a real\u2010time detection tool for MH<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Cases of MH<\/jats:styled-content> from 2003 to 2013 were retrospectively reviewed to confirm the diagnosis of MH<\/jats:styled-content> and to calculate a MH<\/jats:styled-content> clinical grading scale score. The index cases were utilized to develop four electronic data Rules, based on endtidal CO<\/jats:styled-content>2<\/jats:sub> (ETCO<\/jats:styled-content>2<\/jats:sub>) and temperature criteria. The Rules were then applied retrospectively to the index cases and to a full cohort of general operating room (OR<\/jats:styled-content>) patients from January 2012 to June 2012. If criteria for possible MH<\/jats:styled-content> was met, the detection tool generated an alert on the monitor at the patient's bedside.<\/jats:p><\/jats:sec>Results<\/jats:title>We identified seven patients with confirmed MH<\/jats:styled-content> with MH<\/jats:styled-content> Scores ranging from 28 to 70. Using four data Rules, all of our seven index cases were captured and generated an appropriate alert. Median time from MH<\/jats:styled-content> computer alert time to dantrolene administration time among our index cases was 23 min (IQR<\/jats:styled-content> 17\u201377). There were 938 false\u2010positive alerts for possible MH<\/jats:styled-content> (1.8%) when the Rules were applied to a general OR<\/jats:styled-content> cohort of 51 579 total cases from January 2012 to June 2012.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>We demonstrated a real\u2010time MH<\/jats:styled-content> detection tool based on established physiologic criteria that is sensitive enough to capture cases suspicious for MH<\/jats:styled-content>, while limiting false positives to prevent alarm fatigue. This has the potential to notify the provider of possible MH<\/jats:styled-content> such that treatment may be rapidly initiated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12954","type":"journal-article","created":{"date-parts":[[2016,6,27]],"date-time":"2016-06-27T11:57:57Z","timestamp":1467028677000},"page":"876-882","source":"Crossref","is-referenced-by-count":7,"title":["An automated real\u2010time method for the detection of patients at risk for malignant hyperthermia"],"prefix":"10.1111","volume":"26","author":[{"given":"Stephen J.","family":"Gleich","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Strupp","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Colorado School of Medicine Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Wilder","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl J.","family":"Kor","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall","family":"Flick","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199404000-00008"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/msj.21281"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e31818322d2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-011-9289-x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2010.11.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2009.0479"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12007"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198704000-00017"},{"key":"e_1_2_9_10_1","unstructured":"The North American Malignant Hyperthermia Registry of MHAUS Report of Acute Adverse Metabolic or Muscular Reaction to Anesthesia (AMRA Report). Available at:http:\/\/www.mhreg.org\/Forms\/1106AMRA.pdf 2014. Accessed 20 November 2015."},{"key":"e_1_2_9_11_1","unstructured":"Malignant Hyperthermia Association of the United States.The North American Malignant Hyperthermia Registry of MHAUS. Available at:http:\/\/www.mhaus.org\/registry. Accessed 20 April 2016."},{"key":"e_1_2_9_12_1","volume-title":"ICD\u20109 Code Lookup","author":"Centers for Medicare & Medicaid Services","year":"2014"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000467"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182a8fad0"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000269037.66955.F0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000220766.13623.FE"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.06.012"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181c6b9b2"},{"key":"e_1_2_9_19_1","unstructured":"Joint Commission. Medical Device Alarm Safety in Hospitals.Sentinel Event Alert. Avaiable at:http:\/\/www.jointcommission.org\/assets\/1\/18\/SEA_50_alarms_4_5_13_FINAL1.PDF 2013. Accessed 1 November 2015."}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12954","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T11:11:46Z","timestamp":1696245106000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12954"}},"subtitle":[],"editor":[{"given":"Francis","family":"Veyckemans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2016,6,27]]},"references-count":18,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2016,9]]}},"alternative-id":["10.1111\/pan.12954"],"URL":"https:\/\/doi.org\/10.1111\/pan.12954","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,27]]}}}