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Pharmacokinetics of Dantrolene in the CVVH/PE Treatment of Malignant Hyperthermia in a 14-year-old Chinese Boy: A Case Report and Literature Review
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  • Xiao-Xiao LI,
  • Chao Li,
  • Yang Zhou,
  • Xin Xiong,
  • Chuhui Wang,
  • Congya Zhou,
  • Bin Han,
  • Li Yang,
  • Xiangyang Guo
Xiao-Xiao LI
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Chao Li
Peking University Third Hospital
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Yang Zhou
Peking University Third Hospital
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Xin Xiong
Peking University Third Hospital
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Chuhui Wang
Peking University Third Hospital
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Congya Zhou
Peking University Third Hospital
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Bin Han
Peking University Third Hospital
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Li Yang
Peking University Third Hospital
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Xiangyang Guo
Peking University Third Hospital
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Abstract

Malignant hyperthermia (MH) is a rare life-threatening response that triggered by exposure to specific anesthetics commonly used during surgery interventions. Dantrolene is a well-known drug which used as first-line therapy for MH. A 14-year-old Chinese boy with a mutation in RYR1 whose muscle biopsy diagnosis was central core disease (CCD) occurred MH after cervical spine surgery underwent general anesthesia without volatile anesthetics or succinylcholine. The MH crisis treatment workflow was started and intravenous dantrolene was used soon which combined with sequent continuous veno-venous hemofiltration (CVVH) and plasma exchange (PE) therapy. We explored the pharmacokinetics of dantrolene during the treatment and the results showed that a one-compartment model with first-order absorption and elimination was sufficient to characterize dantrolene pharmacokinetics. The clearance estimate for dantrolene was 0.43 mL/(min*kg) and volume of distribution was 0.61 L/kg. The clearance of dantrolene was significantly affected by CVVH and PE.

Peer review status:UNDER REVIEW

01 Aug 2021Submitted to British Journal of Clinical Pharmacology
03 Aug 2021Assigned to Editor
03 Aug 2021Submission Checks Completed
08 Aug 2021Reviewer(s) Assigned
23 Sep 2021Review(s) Completed, Editorial Evaluation Pending