Metabolic Alkalosis

• Metabolic Alkalosis 


  Results from loss of hydrogen ions or addition of base to body fluids.
• Causes: Metabolic Alkalosis

  1. Acid loss:

  • Prolonged vomiting or gastric suctioning: Loss of hydrochloric acid (HCl) from the stomach.
  • Excessive use of diuretics (loop or thiazide): Loss of hydrogen ions through urine.

  1. Excessive bicarbonate:

  • Overuse of antacids: Bicarbonate ingestion.
  • Excessive administration of sodium bicarbonate (e.g., during CPR or metabolic acidosis treatment).

  1. Hormonal causes:

  • Hyperaldosteronism: Increased renal excretion of hydrogen ions.
• Metabolic Alkalosis

  Manifestations:

  1. Hypocalcemia (alkalosis damages ionized calcium)
  2. Hypoventilation
  3. Hypokalemia
• Metabolic Alkalosis

  Management:

  1. Diamox (Acetazolamide). This is carbonic anhydrase inhibitor that increases excretion of bicarbonate by the kidneys.
  2. Treat underlying cause.
• Metabolic Alkalosis

  Bicarbonate Excess