{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:51:06Z","timestamp":1793641866242,"version":"4.5.1"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Malignant hyperthermia (MH) is a fatal hypermetabolic reaction of skeletal muscle, triggered by exposure to volatile anesthetic agents or depolarizing muscle relaxants. It typically exhibits hypercarbia, muscle rigidity, tachycardia, and hyperthermia. Diagnosis is often confirmed through a muscle biopsy for the in vitro contracture test or by identifying pathogenic genetic variants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation:<\/jats:title>\n                    <jats:p>We report 2 cases of suspected MH. The first case involved a 4-year-old female (20\u2009kg) undergoing adenotonsillectomy, and the second involved a 13-year-old female (56\u2009kg) who underwent pedicle screw fixation surgery. Both patients had unremarkable medical histories. During maintenance of general anesthesia with sevoflurane, they developed clinical signs highly suggestive of MH\u201410\u2009minutes after exposure in the first case and 120\u2009minutes after exposure in the second case. Both cases were managed with dantrolene and supportive care. In the first case, dantrolene was administered 4\u2009hours after the initial signs, by which time significant rhabdomyolysis had already developed. In the second case, early administration within 10\u2009minutes was associated with a much milder degree of rhabdomyolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Early recognition of symptoms and accurate differentiation of MH from similar conditions are essential for favorable outcomes. Prompt administration of dantrolene at the first sign of an MH reaction is critical for effective management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795476251349345","type":"journal-article","created":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T22:59:16Z","timestamp":1749941956000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of Suspected Malignant Hyperthermia With Dantrolene: Clinical Insights From 2 Case Reports in a Single-Center Experience"],"prefix":"10.1177","volume":"18","author":[{"given":"Nguyen","family":"Trung Kien","sequence":"first","affiliation":[{"name":"Military Medical Department, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran","family":"Nguyen Nhat","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Saint Paul General Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do","family":"Dinh Tung","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Saint Paul General Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran","family":"Quang Hai","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Saint Paul General Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Thi Nguyet","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Saint Paul General Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham","family":"Quang Minh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Hanoi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luu","family":"Quang Thuy","sequence":"additional","affiliation":[{"name":"Center of Anesthesia and Surgical Intensive Care, Viet Duc Hospital, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Quyet Thang","sequence":"additional","affiliation":[{"name":"Vietnam Society of Anesthesiologists, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngo","family":"Van Dinh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Central Military Hospital 108, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vu","family":"The Anh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam"},{"name":"Translational Neurophysiology Lab, Institute of Bioelectronic Medicine, The Feinstein Institute for Medical Research, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen","family":"Huu Tu","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Hanoi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1326-3681","authenticated-orcid":false,"given":"Nguyen","family":"Dang Thu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-015-0310-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-200309000-00039"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001878"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.09.029"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.17085\/apm.22260"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-018-1108-0"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318190bb08"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15317"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182937d8b"},{"issue":"5","key":"e_1_3_3_11_2","first-page":"1039","article-title":"Creatine kinase alterations after acute malignant hyperthermia episodes and common surgical procedures","volume":"81","author":"Antognini JF.","year":"1995","unstructured":"Antognini JF. Creatine kinase alterations after acute malignant hyperthermia episodes and common surgical procedures. Anesth Anal. 1995;81(5):1039-1042.","journal-title":"Anesth Anal"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000265148.86566.68"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq243"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198310000-00002"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/03602530902843483"},{"key":"e_1_3_3_16_2","unstructured":"Malignant Hyperthermia Association of the United States. After a crisis. 2025. 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