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PEDIATRIC ANESTHESIOLOGY

Postoperative Hyperthermia, Rhabdomyolysis, Critical Temperature, and Death in a Former Premature Infant After His Ninth General Anesthetic

Aparna Phadke, MD^*, Lynn M. Broadman, MD^*, Barbara W. Brandom, MD^*, John Ozolek, MD, and Peter J. Davis, MD^*

From the Departments of *Anesthesiology and Pathology, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Lynn M. Broadman, MD, Department of Anesthesiology, Children's Hospital of Pittsburgh, 3705 Fifth Ave., Pittsburgh, PA 15213. Address e-mail to lbroadman{at}aol.com.

Abstract

An 8-mo-old infant born at 24-wk of gestation died unexpectedly 12 h after his ninth uneventful general anesthetic. Preoperatively, he required low-flow nasal oxygen due to bronchopulmonary dysplasia, chronic diuretic therapy, and IV alimentation. As planned preoperatively, the infant remained tracheally intubated after his elective surgery and went to the Neonatal Intensive Care Unit in stable condition. However, over the next 6 h, he developed fever. The diagnosis of postoperative sepsis was considered. One hour before his death his temperature reached 43°C. Autopsy documented Duchenne's muscular dystrophy and renal tubules containing myoglobin.

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