Malignant Hyperthermia - 2020

Malignant hyperthermia is a rare, life-threatening disease that is charactarized by pathologic hypermetabolic state in muscular tissues that is triggered by specific anaesthetic agents. Firstly, our educational algorithm will lead you step by step through a situation with unexpected case of MH during surgery, show you how to remain calm, assess the situation and save the patient's life. The other part of the algorithm is dedicated to anaesthetic care of a patient who can have genetic predisposition for delevoping MH. It is crucial to prepare your workplace and medical staff for the specifics of anaesthesiological management of this patient and the possibility of further complications. Last but not least, you will learn about means of diagnostics of MH in the Czech Republic.

malignant hyperthermia
in vitro contracture test
trigger-free anaesthesia
Published at: 8.5.2020


Jonathan Bilmen, MD, PhD
Consultant Anaesthetist, Malignant Hyperthermia Unit, The Leeds Teaching Hospital, Leeds, United Kingdom

The MH algorithm published by is interactive, informative, educational and appropriately lighthearted. Options can lead to burying the patient, reviewing why an answer is incorrect, or successfully answering the posed question. At all points, information is imparted to the reader which is both relevant and appropriate to the level of understanding of the target audience. It is a well-considered and executed series of scenarios which gives the reader a flavour of the intricacies of Malignant Hyperthermia, as well as educating them on how to diagnose, treat and prevent further recurrences. Overall, an excellent learning tool that fulfils the education requirements of its target audience.


European Malignant Hyperthermia Group, EMHG [online]. 2019, [cit. 2020-03-22]. Available at

GLAHN, K.P.E., F.R. ELLIS, P.J. HALSALL, C.R. MÜLLER, M.M.J. SNOECK, A URWYLER and F WAPPLER. Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group. British Journal of Anaesthesia [online]. 2010, 105(4), 417-420 [cit. 2020-03-22]. DOI: 10.1093/bja/aeq243. ISSN 00070912. Available at:

KIM, Tae W. a Michael E. NEMERGUT. Preparation of Modern Anesthesia Workstations for Malignant Hyperthermia–susceptible Patients. Anesthesiology [online]. 2011, 114(1), 205-212 [cit. 2020-04-13]. DOI: 10.1097/ALN.0b013e3181ee2cb7. ISSN 0003-3022. Available at:

BILMEN, J. G. a P. M. HOPKINS. The use of charcoal filters in malignant hyperthermia: have they found their place? Anaesthesia [online]. 2019, 74(1), 13-16 [cit. 2020-04-13]. DOI: 10.1111/anae.14407. ISSN 00032409. Available at:

HOPKINS, P.M., H. RÜFFERT, M.M. SNOECK, T. GIRARD, K.P.E. GLAHN, F.R. ELLIS, C.R. MÜLLER a A. URWYLER. European Malignant Hyperthermia Group guidelines for investigation of malignant hyperthermia susceptibility. British Journal of Anaesthesia [online]. 2015, 115(4), 531-539 [cit. 2020-04-13]. DOI: 10.1093/bja/aev225. ISSN 00070912. Available at:

European Malignant Hyperthermia Group. Malignant hyperthermia during pregnancy. Recommendations [online]. EMHG, 2019. [Cit. 2020-03-22]. Available at:

Other versions of the algorithm