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All Journal Cermin Dunia Kedokteran
Anderson Surya, Kevin
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Health Professions

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Hipertermia Maligna: Tinjauan Pustaka: Tinjauan Pustaka Pandrya, Carla Oktaviani; Anderson Surya, Kevin
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1746

Abstract

Malignant hyperthermia (MH) is a life-threatening syndrome triggered by inhaled anesthetics and depolarizing muscle relaxants like succinylcholine, leading to uncontrolled skeletal muscle hypermetabolism. This condition is marked by massive calcium release from the endoplasmic reticulum, causing muscle rigidity, increased temperature, and metabolic disturbances. The genetic basis of MH is linked to mutations in the CACNA1S gene, which encodes a subunit of the dihydropyridine receptor (DHPR), which is essential to muscle calcium regulation. The condition is often triggered during surgeries requiring general or regional anesthesia, particularly in individuals with a family history of MH. Clinical manifestations may include hypercapnia, tachycardia, acidosis, rhabdomyolysis, and multi-organ dysfunction. Early diagnosis remains challenging because MH may resemble other hypermetabolic conditions and can progress rapidly if left untreated. Treatment involves the administration of dantrolene, a post-synaptic muscle relaxant that reduces excitation-contraction coupling (ECC) and mitigates hypermetabolism. Early recognition and prompt dantrolene administration are vital for successful management.
Sindrom Infus Terkait Propofol: Diagnosis dan Penatalaksanaan: Tinjauan Pustaka Hariyanto, Hori; Oktaviani Pandrya, Carla; Anderson Surya, Kevin
Cermin Dunia Kedokteran Vol 53 No 08 (2026): Agustus 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i08.1747

Abstract

Propofol-related infusion syndrome (PRIS), first described in 1990, is a rare and dangerous condition caused by high-dose (> 4 mg/kg/hour) and prolonged (> 48 hours) administration of propofol in mechanically ventilated patients. This condition is characterized by a progressive constellation of multi-organ failure. The main clinical presentations include severe metabolic and lactic acidosis, rhabdomyolysis, acute liver failure, lipemic blood, hyperkalemia, and cardiovascular impairment or marked bradycardia, which can lead to cardiac arrest. The mechanism of PRIS remains unclear and is likely controversial. The most effective way to prevent PRIS is to remain vigilant and maintain a high level of suspicion during prolonged propofol administration. Early recognition of clinical manifestations, prompt discontinuation of propofol infusion, and timely initiation of supportive management are essential to reduce morbidity and mortality associated with PRIS. Understanding the underlying pathophysiology and identifying patients at high risk may improve preventive strategies and optimize outcomes in critically ill patients receiving prolonged propofol infusion.
Co-Authors Hori Hariyanto Oktaviani Pandrya, Carla Pandrya, Carla Oktaviani