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- W4236326045 abstract "To the Editor: We read with great interest the report by Koehntop et al. [1] describing the prophylactic administration of dantrolene in a patient with central core disease who needed a cardiac transplantation for a severely dilated cardiomyopathy. The report apparently demonstrates that dantrolene given before, during, and after the transplantation was well tolerated in this patient, resulting in exceedingly high plasma levels (11 [micro sign]g/mL). However, the question remains open as to why dantrolene was administered at all. Despite the fact that central core disease is associated, although not invariably [2], with a susceptibility to malignant hyperthermia, we cannot see any indication for the administration of dantrolene to this patient. Besides the well known side effects of dantrolene (muscle weakness, dizziness, fatigue), dantrolene has negative inotropic effects assumed to be comparable to those of calcium channel blockers [3]; one case of cardiac failure caused by an overdose of dantrolene has even been reported [4]. However, there is comprehensive literature proving that stress-free anesthesia can be safely provided without the prophylactic administration of dantrolene in patients susceptible to malignant hyperthermia if triggering drugs are avoided [5]. We therefore doubt that the risk/benefit ratio of administering dantrolene to a patient with severe cardiomyopathy outside the context of a controlled study can be assessed favorably from an ethical point of view. Andrea Michalek-Sauberer, MD Hermann Gilly, PhD Department of Anesthesiology and General Intensive Care; University of Vienna; A-1090 Vienna, Austria" @default.
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- W4236326045 date "1998-04-01" @default.
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- W4236326045 title "Prophylactic Use of Dantrolene in a Patient with Central Core Disease" @default.
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- W4236326045 doi "https://doi.org/10.1213/00000539-199804000-00047" @default.
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