Malignant hyperthermia as a rare cause of SIRS after cardiac surgery

Background Use of extracorporal circulation (cardiopulmonary bypass) during cardiac surgery can cause a systemic inflammatory response. This so called “post-perfusionsyndrome” (PPS) occurs in about a quarter of patients and results in clinical signs and symptoms of “systemic inflammatory response syndrome” (SIRS) in 2-10% of patients. This condition is clinically associated with mild hyperthermia, acidosis, tachycardia and vasoplegia. It is generally treated with cristalloid infusions and vasopressors, and is mostly subsided by the next morning, at the latest after 48h. Malignant hyperthermia is associated with a severe combined (respiratory and metabolic) acidosis, hyperlactatemia, hypercapnia, hyperthermia, grossly elevated serum levels of creatine kinase (CK) and acute renal failure.