Continuous veno-venous hemofiltration for the immediate management of massive rhabdomyolysis after fulminant malignant hyperthermia in a bodybuilder.

WE report a case of unsuspected fulminant malignant hyperthermia (MH) complicated by life-threatening hy-perkalemia and massive rhabdomyolysis, which were managed successfully by early institution of continuous veno-venous hemofiltration (CVVH). In addition, we de-scribe the kinetics of myoglobin elimination during prolonged hemofiltration. analog scale and demonstrated an increase in passive range of motion with no incident pain. The patient showed none of the previously observed disorientation in regard to place and time. She was conversant and coherent. Mild sedation resolved over the next 2 days. Her infusion was adjusted to a rate of intraventricular morphine at 20 m g/h and clonidine at 0.1 m g/h. The patient’s improved condition was sustained, and a permanent intraventricular infusion pump was surgically placed. She was discharged to a care facility. The patient remained comfortable and continued to receive the same rates of morphine and clonidine via the intraventricular pump, with no additional doses of breakthrough oral opioids until her death on November 15, 2000.