Abstract
Purpose
To analyze metabolic changes associated with a fulminant malignant hyperthermia (MH) crisis developed spontaneously in an MH susceptible pig which was part of 12 pigs undergoing metabolic investigation (six MH susceptible and six controls) and had been anaesthetized with a non-triggering agent (pentobarbitone).
Methods
The pig was placed in a cradle and then inserted into a 4.7 T magnet bore. The semi-membranosus muscle was submitted to three repetitive stimulation-recovery sessions. 31 -P magnetic resonance spectra and mechanical data were recorded.
Results
The pig developed a non-rigid MH crisis dunng recovery from the second set of expenments. Although no mechanical work was performed, dramatic metabolic changes were noted. Twitch tension decreased progressively reaching zero while mouth temperature continuously increased to 44. 5°C. Phosphocreatine (PCr) consumption was coupled to Pi accumulation. Also, a marked intracellular acidosis and a large accumulation of phosphomonoesters (PME) were observed, probably as a result of massive glycolysis activation. Interestingly, ATP level remained constant.
Conclusion
These irreversible mechanisms may constitute a metabolic dead-end coupling calcium pumping ATP-consuming processes and ATP synthesis through PCr breakdown and anaerobic glycolysis They do not differ from metabolic changes previously reported in rigid forms of MH crisis.
Résumé
Objectif
Analyser les changements métaboliques associés à une crise d’hyperthermie maligne fulminante (HM) spontanée survenue chez un porc sensible faisant partie d’un groupe de 12 porcs soumis à une étude métabolique (six HM sensibles et six contrôles) et anesthésiés avec un agent non déclenchant (le pentobarbitone).
Méthodes
Iminobilisé dans un panier, le porc a été inséré dans un champ magnétique de 4,7 T. Son muscle semi-membraneux a subi trois sessions de stimulations-récupérations répétées. Les spectres de résonance magnétique 31-P et les données mécaniques ont été enregistrés.
Résultats
Le porc a développé une crise d’HM non rigide pendant la récupération de la seconde série d’épreuves. Même en absence de travail mécanique, on a pu noter des changements métaboliques remarquables. La tension du twitch a diminué progressivement pour atteindre zéro alors que la température orale augmentait à 44.5°C. La consomination de la phosphocréatnine (PCr) était couplée à l’accumulation de Pi. En outre, on observait une acidose intracellulaire importante et une forte accumulation de phosphomonoesters (PME), résultats probables d’une activation massive de la glycolyse. Il est intéressant de mentionner que le niveau d’ATP est demeuré constant.
Conclusion
Ces mécanismes irréversibles peuvent constituer les processus métaboliques terminaux consominateurs d’ATP du couplage de la pompe calcique et de la synthèse par dégradation de PCr et glycolyse anaérobique. Ils ne sont pas différents des changements métaboliques anténeurement observés pendant les crises d’HM avec rigidité.
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Kozak-Ribbens, G., Bendahan, D., Rodet, L. et al. Metabolic events with spontaneous malignant hyperthermia crisis in an anaesthetized pig. Can J Anaesth 44, 757–764 (1997). https://doi.org/10.1007/BF03013392
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DOI: https://doi.org/10.1007/BF03013392