What can cause hyperkalemia in malignant hyperthermia?

Hyperkalemia in malignant hyperthermia is primarily caused by rhabdomyolysis. Malignant hyperthermia is a rare, life-threatening condition triggered by certain anesthetics and muscle relaxants, which leads to an uncontrolled release of calcium from the sarcoplasmic reticulum in skeletal muscle. This condition causes intense muscle contractions, leading to muscle damage, which can release intracellular potassium into the bloodstream, resulting in elevated serum potassium levels, or hyperkalemia.

Rhabdomyolysis refers to the breakdown of muscle tissue, which further exacerbates potassium release as injured myocytes leak their contents, including potassium, into the extracellular space. This uncontrolled release significantly contributes to the hyperkalemia observed in patients experiencing malignant hyperthermia.

Other options, while related to different physiological processes, do not directly and specifically link to the pathophysiology of malignant hyperthermia in the way that rhabdomyolysis does. For example, dehydration can indeed affect electrolyte levels but is not a primary cause of hyperkalemia in this specific context. Similarly, cardiac arrest and hospital-acquired infections may present their own electrolyte imbalances but do not typically lead to hyperkalemia following malignant hyperthermia.