Table 1 Criteria used in the Clinical Grading Scale for Malignant Hyperthermia
Process | Indicator |
|---|---|
I: Rigidity | a. Generalized muscular rigidity (in absence of shivering due to hypothermia, or during or immediately following emergence from inhalational anesthesia) |
b. Masseter spasm shortly following succinylcholine administration | |
II: Muscle Breakdown | a. Elevated creatine kinase >20,000Â IU after anesthetic that included succinylcholine |
b. Elevated creatine kinase >10,000Â IU after anesthetic without succinylcholine | |
c. Cola colored urine in perioperative period | |
d. Myoglobin in urine >60 μg/L | |
e. Myoglobin in serum >170 μg/L | |
f. Blood/plasma/serum K+ > 6 mEq/L (in absence of renal failure) | |
III: Respiratory Acidosis | a. PETCO2 > 55 mmHg with appropriately controlled ventilation |
b. Arterial PaCO2 > 60 mmHg with appropriately controlled ventilation | |
c. PETCO2 > 60 mmHg with spontaneous ventilation | |
d. Arterial PaCO2 > 65 mmHg with spontaneous ventilation | |
e. Inappropriate hypercarbia (in anesthesiologist’s judgment) | |
f. Inappropriate tachypnea | |
IV: Temperature Increase | a. Inappropriately rapid increase in temperature (in anesthesiologist’s judgement) |
b. Inappropriately increased temperature > 38.8 °C (101.8 °F) in the perioperative period (in anesthesiologist’s judgment) | |
V: Cardiac Involvement | a. Inappropriate sinus tachycardia |
b. Ventricular tachycardia or ventricular fibrillation |