Dantrolene in the Treatment of Refractory Hyperthermic Conditions in Critical Care: A Multicenter Retrospective Study

Shonali C. Pawar¹, Henry Rosenberg^1,2*, Robert Adamson³, Jennifer A. LaRosa⁴, Ronald Chamberlain¹

¹Department of Surgery, Saint Barnabas Medical Center, Livingston, USA.
²Department of Medical Education and Clinical Research, Saint Barnabas Medical Center, Livingston, USA.
³Corporate Pharmaceutical Sciences, Barnabas Health Care, Livingston, NJ, USA.
⁴Department of Pulmonary and Critical Care Medicine, Newark Beth Israel Medical Center, Newark, NJ, USA.

DOI: 10.4236/ojanes.2015.54013                

Abstract

Purpose: To examine the use of intravenous dantrolene in hospitalized patients. Materials and Methods: Medical Records of patients treated with intravenous dantrolene between 2007 and 2012 at 6 teaching hospitals were reviewed. Temperature, muscle rigidity, creatine kinase levels, and mortality were assessed in association with dantrolene use. Results: Twenty-five patients received intravenous dantrolene, 9 patients with neuroleptic malignant syndrome (NMS), 8 with hyperthermia due to sepsis, 4 with NMS and sepsis, 2 for malignant hyperthermia (MH), and 2 with hypermetabolic syndrome associated with juvenile diabetic ketoacidosis. Dantrolene was administered as a bolus of 1 - 3 mg/kg. Core temperature decreased after dantrolene administration in all groups but significant only for MH, NMS cases (Pre 102.3 ± 0.9°F vs. Post 99.5 ± 0.9°F; p < 0.001), in Sepsis cases (Pre 104.3 ± 1.5°F vs. Post 100.6 ± 1.0°F; p < 0.001). Mean rigidity scores decreased in all groups but significant only for NMS cases, and mean CK did not change significantly in any group. Conclusion: Dantrolene was associated with reductions in temperature and rigidity in hyperthermia of diverse origins in patients admitted to Intensive care settings.

Keywords

Dantrolene, Malignant Hyperthermia, Neuroleptic Malignant Syndrome, Sepsis

Conflicts of Interest

The authors declare no conflicts of interest.

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