During a malignant hyperthermia crisis, which metabolic change is typically observed?

During a malignant hyperthermia crisis, which metabolic change is typically observed?

• A. Decreased CO2
• B. Decreased potassium
• C. Increased pH
• D. Increased CO2

Answer: (D)

Malignant hyperthermia drives a powerful hypermetabolic crash in skeletal muscle because calcium is released uncontrollably from the sarcoplasmic reticulum. That sustained calcium cycling pushes a huge amount of ATP use to resequester calcium and maintain contraction, which in turn ramps up cellular respiration and heat production. The increased metabolic activity yields a lot more CO2 as a byproduct, so CO2 accumulates in the blood and is seen as rising end-tidal and arterial CO2. This pattern also comes with lactic acidosis and potassium release from muscle, but the notable metabolic change you’d expect is increased CO2. Decreased CO2, increased pH, or decreased potassium would not fit the typical MH picture.

Malignant hyperthermia drives a powerful hypermetabolic crash in skeletal muscle because calcium is released uncontrollably from the sarcoplasmic reticulum. That sustained calcium cycling pushes a huge amount of ATP use to resequester calcium and maintain contraction, which in turn ramps up cellular respiration and heat production. The increased metabolic activity yields a lot more CO2 as a byproduct, so CO2 accumulates in the blood and is seen as rising end-tidal and arterial CO2. This pattern also comes with lactic acidosis and potassium release from muscle, but the notable metabolic change you’d expect is increased CO2. Decreased CO2, increased pH, or decreased potassium would not fit the typical MH picture.