A POSSIBLE MEANS OF RAPID COOLING IN THE EMERGENCY TREATMENT OF MALIGNANT HYPERPYREXIA

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Abstract
A possible means of rapid cooling in the emergency treatment of malignant hyperpyrexia, peritoneal dialysis using a cold dialysate, is described. Experimental observations in a young man on a regular peritoneal dialysis regime showed that significant heat extraction can be obtained when either a cool (20 ΔC) or cold (9 ΔC) dialysis fluid is used. The maximum heat exchange observed was 17.5 kj/min when 2 litre of cold dialysate was instilled for a mean time of 10 min. This rate of heat exchange is within the 10–40 kj/min range of excess heat production that occurs in malignant hyperpyrexia. Since peritoneal dialysis is, technically, a very quick and simple procedure, it is suggested that it might play a very useful role in the emergency treatment of malignant hyperpyrexia. The dialysis treatment would also correct some of the biochemical disturbances that occur in this condition.

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