Extreme metabolic alkalosis in intensive care

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Swagata Tripathy
ISSN
0972-5229
DOI
10.4103/0972-5229.60175
Volume
13
Issue
4
Publishing Year
2009
Pages
4
Author Affiliations
    1. Department of Anaesthesia and Critical Care, Kalinga Institute of Medical Sciences, Medical College, Bhubaneswar, India
  • Article keywords
    Extreme metabolic alkalosis, respiratory compensation, treatment

    Abstract

    Metabolic alkalosis is a commonly seen imbalance in the intensive care unit (ICU). Extreme metabolic alkalemia, however, is less common. A pH greater than 7.65 may carry a high risk of mortality (up to 80%). We discuss the entity of life threatening metabolic alkalemia by means of two illustrative cases - both with a pH greater than 7.65 on presentation. The cause, modalities of managing and complications of this condition is discussed from the point of view of both the traditional method of Henderson and Hasselbalch and the mathematical model based on physiochemical model described by Stewart. Special mention to the pitfalls in managing patients of metabolic alkalosis with concomitant renal compromise is made.

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