Circulation 81,489 • Volume 22, No. 1 • Spring 2007   Issue PDF

The Icarus Effect: The Influence of Diluent Warming on Dantrolene Sodium Mixing Time

Donna Landriscina, CRNA, MSNA

To the Editor

The manuscript from this study was recently published in the April issue of the AANA Journal.4 This letter is written to disseminate this information in the event someone experiences a MH crisis, and to promote patient safety that may improve patient outcome. A practical method, using a reliable and safe warming device readily available to the anesthesia provider, and ubiquitous to the operating room environment, speeds the time to administration of dantrolene sodium, potentially reducing morbidity and mortality associated with MH. Perhaps our research, in addition to the work of Mitchell and Leighton and Quraishi et al., will lay the groundwork for changing MH treatment protocols, and help further reduce morbidity and mortality.

Table 1

Donna Landriscina, CRNA, MSNA
Richmond, VA



  1. Chartrand D. Rapid intervention for an episode of malignant hyperthermia. Can J Anaesth 2003;50:104-7.
  2. Mitchell LW, Leighton BL. Warmed diluent speeds dantrolene reconstitution. Can J Anaesth 2003;50:127-30.
  3. Quraishi SA, Frederick KO, Bosseau Murray W. Dantrolene reconstitution: can warmed diluent make a difference? J Clin Anesth 2006;18:339-42.
  4. Baker KR, Landriscina D, Kartchner H, Mirkes DM. The Icarus effect: the influence of diluent warming on dantrolene sodium mixing time. AANA J 2007 Apr;75(2):101-6.