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Anesth Analg 2006;102:815-817
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000196515.06945.fb

ANESTHETIC PHARMACOLOGY

Negative Arterial to End-Tidal Carbon Dioxide Gradient: An Additional Sign of Malignant Hyperthermia During Desflurane Anesthesia

Igor Kwetny, MD, DEAA, and Brendan T. Finucane, MB, BCh, FRCPC

Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada

Widespread use of desflurane anesthesia has changed the clinical presentation of malignant hyperthermia (MH). Delayed onset of MH symptoms has been reported previously. A negative gradient between arterial to end-tidal CO2 ([a-ET]Pco2) was observed during anesthesia in pregnant patients and infants and has been associated with increased CO2 production, increased cardiac output, reduced functional residual capacity, and low lung compliance. The same conditions exist in cases of MH crisis. We describe an unusual case of MH in which a negative value of (a-ET) Pco2 gradient has been used as diagnostic and monitoring tool.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.