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Related Experiment Videos

Treating severe metabolic alkalosis.

W J Martin, G R Matzke

    Clinical Pharmacy
    |January 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Metabolic alkalosis treatment involves fluid and electrolyte therapy. For rapid correction or intolerance, mineral acids like hydrochloric acid are used, especially in patients with liver or kidney dysfunction.

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    Area of Science:

    • Nephrology
    • Internal Medicine
    • Biochemistry

    Background:

    • Metabolic alkalosis involves an arterial pH above 7.45, challenging the body's buffering systems (tissue, respiratory, renal).
    • Kidneys are crucial for correcting severe metabolic alkalosis, but conditions like volume contraction can impair this function.
    • Metabolic alkalosis lacks unique symptoms, complicating diagnosis and treatment initiation.

    Observation:

    • Conventional treatment focuses on fluid and electrolyte balance, relying on the body's natural correction mechanisms.
    • Mineral acids are considered when faster resolution is required or conventional therapy is not tolerated.
    • Ammonium chloride and arginine monohydrochloride require hepatic conversion, posing challenges for patients with liver dysfunction.

    Findings:

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  • Dilute hydrochloric acid (0.1-0.2 N) administered intravenously via a central-venous catheter is a viable alternative for patients with hepatic or severe renal dysfunction.
  • Dosage guidelines and formulation procedures for intravenous hydrochloric acid are detailed.
  • Other therapeutic options include dialysis, acetazolamide, and cimetidine.

    • Implications:

    • Fluid and electrolyte therapy is sufficient for most metabolic alkalosis cases.
    • Intravenous mineral acid administration is indicated for rapid correction or intolerance to conventional therapy.
    • Intravenous hydrochloric acid is the preferred treatment for patients with hepatic or severe renal impairment requiring mineral acid therapy.