Malignant hyperthermia on ICU – sudden attack of the “snake”

Background Fulminant malignant hyperthermia (MH) is a rare emergency that should be known to every medical professional although practical exposure is a rarity even for experienced anesthesiologists. The vast majority of documented MH cases occurred during general anesthesia in the operating room following application of volatile anesthetics and/or depolarizing muscle relaxants. With increasing utilization of the anesthetic conserving device AnaConDa for sedation of intensive care patients, who could benefit from reduced duration of mechanical ventilation and earlier hospital discharge, volatile anesthetics made their way into the intensive care unit (ICU).