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- Title
Management von Patienten mit MELAS-Syndrom : Ein Fallbericht und allgemeine Besonderheiten aus anästhesiologischer Sicht.
- Authors
Roth, Sebastian; Nienhaus, Johannes; Nickel, Frank; Kindgen-Milles, Detlef; Kienbaum, Peter; Huhn, Ragnar
- Abstract
<bold>Background: </bold>Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare progressive disease with acute neurological episodes caused by a mitochondriopathy. Due to a defect of oxidative phosphorylation in the respiratory chain, there is impaired mitochondrial energy production with subsequent lactic acidosis, especially in situations with increased stress. Due to the high risk of metabolic derailment MELAS syndrome is a great challenge with respect to the perioperative management of anesthesia.<bold>Objective: </bold>This article gives a general overview of the special features of anesthesia management in patients with MELAS syndrome. A case report is presented in order to demonstrate how intraoperative parenteral nutrition can possibly be used to counteract the formation of lactic acidosis.<bold>Material and Methods: </bold>A systematic review of the literature was performed. As only very few reports on MELAS syndrome are available, a case report was also integrated into this overview article for illustration purposes.<bold>Results and Conclusion: </bold>Patients with MELAS syndrome represent a challenging cohort with respect to management of anesthesia and an intensive monitoring of the metabolic status is crucial. In cases of increasing lactate values, the administration of intraoperative parenteral nutrition seems to be a suitable approach to avoid lactic acidosis and to improve the perioperative treatment of patients with MELAS syndrome in the future.
- Subjects
GENERAL anesthesia; ANESTHESIOLOGY; ANESTHESIA; INTRAOPERATIVE care; SYSTEMATIC reviews; MITOCHONDRIAL encephalomyopathies
- Publication
Anaesthesist, 2020, Vol 69, Issue 7, p471
- ISSN
0003-2417
- Publication type
journal article
- DOI
10.1007/s00101-020-00793-8