ISSN: 0022-1198
CODEN: JFSCA
Page Count: 3

Hemolysis and Hyperkalemia Complicate Malignant Hyperpyrexia During Anesthetic Death
Reay, DT
Chief medical examiner, King County Medical Examiner's Office, WA

Eisele, JW
Medical examiner, King County Medical Examiner's Office, WA

Ward, RJ
Professor, University of Washington School of Medicine, WA

Horton, WG
Staff anesthesiologist, Virginia Mason Hospital, WA

(Received 2 April 1985; accepted 3 September 1985)

Abstract

A healthy, 15-year-old male received a thiopental, nitrous oxide, oxygen, enflurane anesthetic for appendectomy. Cardiac arrest, following succinylcholine administration, was associated with marked hyperkalemia (potassium levels 8.7 to 11.6 meq), hemolysis (hematocrit fall from 41.7 to 26.6%, plasma hemoglobin 27 mg/dL), and creatine phosphokinase (CPK) elevation (8900 units). Vigorous resuscitative therapy including dantrolene was unsuccessful.

The diagnosis of malignant hyperthermia was made by the marked CPK elevation on blood samples drawn during resuscitation and analyzed by the Medical Examiner's Office.

Keywords:
pathology and biology, anesthetics, hyperthermia

Paper ID: JFS12285J
DOI: 10.1520/JFS12285J
ASTM International is a member of CrossRef.