一篇叙述性专家综述，旨在总结恶性高热 (MH) 危重患者的临床流行病学和治疗。我们进行了 Medline 搜索，以找出描述 MH 流行病学、病理生理学和治疗的相关文章。主要MH组织的指南也纳入了本次综述。回顾了ICU和围手术期MH的相关研究。对相关研究的数据进行了总结和定性评估。MH是遗传易感人群中由吸入挥发性麻醉剂和琥珀胆碱引发的严重反应患者。该病症的特点是接触触发药物后出现早期（分钟至小时）体温升高、高碳酸血症和肌肉僵硬，并可能出现凝血病、横纹肌溶解症和急性肾损伤等并发症。急性管理需要协调的多学科团队方法，并使用丹曲林、主动降温和过度通气进行具体管理。疑似 MH 反应对于患者及其家人未来的麻醉暴露具有重要影响。所有可疑的反应均应在专门的 MH 检测中心使用肌肉挛缩和基因检测进行随访。 ICU 中吸入麻醉剂的使用增加强调需要加强 MH 诊断和管理的教育，以确保最佳的患者镇静护理和安全。版权所有 © 2024 重症监护医学协会和 Wolters Kluwer Health, Inc. 保留所有权利。

A narrative expert review aiming to summarize the clinical epidemiology and management of critically ill patients with malignant hyperthermia (MH).Medline searches were conducted to identify relevant articles describing the epidemiology, pathophysiology, and management of MH. Guidelines from key MH organizations were also incorporated into this review.Relevant studies regarding MH in both ICU and perioperative settings were reviewed.Data from relevant studies were summarized and qualitatively assessed.MH is a severe reaction triggered by inhalational volatile anesthetics and succinylcholine in genetically susceptible patients. The condition is characterized by an early onset (min to hr) rise in temperature, hypercarbia, and muscular rigidity following exposure to triggering medications with potential complications of coagulopathy, rhabdomyolysis, and acute kidney injury. Acute management necessitates a coordinated multidisciplinary team approach with specific management using dantrolene, active cooling, and hyperventilation. A suspected MH reaction has important implications for future anesthetic exposure for both the patient and their family. All suspected reactions should be followed up at a specialized MH testing center using muscle contracture and genetic testing.Increasing use of inhalational anesthetics in the ICU underscores the need for enhanced education on the diagnosis and management of MH to ensure optimal patient sedation care and safety.Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.