Metabolic alkalosis diagnostic study of choice: Difference between revisions
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=== Study of choice === | === Study of choice === | ||
* The following result of ABG is confirmatory of | * The following result of ABG is confirmatory of Metabolic Alkalosis: | ||
** pH | ** Blood pH is elevated more than 7.45. | ||
** | ** Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter. | ||
** | **Partial pressure of CO2 reduces to combat elevated bicarbonate. | ||
* Investigations: | * Investigations: | ||
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! style="background: #696969; color: #FFFFFF; text-align: center;" |[[ABG]] | ! style="background: #696969; color: #FFFFFF; text-align: center;" |[[ABG]] | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |<100% | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |<100% | ||
|- | |- | ||
! style="background: #696969; color: #FFFFFF; text-align: center;" |[[Central VBG]] | ! style="background: #696969; color: #FFFFFF; text-align: center;" |[[Central VBG]] | ||
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===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
The following result of Arterial blood gas analysis is confirmatory of Metabolic Alkalosis: | The following result of Arterial blood gas analysis is confirmatory of Metabolic Alkalosis: | ||
** pH | ** Blood pH is elevated more than 7.45. | ||
** | ** Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter. | ||
** | **Partial pressure of CO2 reduces to combat elevated bicarbonate. | ||
===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
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=== Diagnostic Criteria === | === Diagnostic Criteria === | ||
* The diagnosis of Metabolic Alkalosis is based on the | * The diagnosis of Metabolic Alkalosis is based on the laboratory diagnosis, which includes: | ||
** Blood pH is elevated more than 7.45. | |||
** Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter. | |||
**Partial pressure of CO2 reduces to combat elevated bicarbonate. | |||
==References== | ==References== | ||
Latest revision as of 05:08, 25 February 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marufa Marium, M.B.B.S[2]
Overview
Arterial Blood Gas Analysis(ABG) is gold standard for diagnosis of Metabolic Alkalosis. Other laboratory tests, for instance Basic metabolic panel, serum aldosterone, serum renin, Urine analysis, urine pH, Urine chloride and sodium, Chest X-ray, Abdominal USG/CT are done to rule out the causes of metabolic alkalosis.
Diagnostic Study of Choice
Study of choice
- The following result of ABG is confirmatory of Metabolic Alkalosis:
- Blood pH is elevated more than 7.45.
- Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter.
- Partial pressure of CO2 reduces to combat elevated bicarbonate.
- Investigations:
- Among patients who present with clinical signs of Metabolic Alkalosis, the ABG is the most efficient test for diagnosis.
The comparison of various diagnostic studies for Metabolic alkalosis
| Test | Sensitivity | Specificity |
|---|---|---|
| ABG | <100% | <100% |
| Central VBG | 100% | 100% |
Diagnostic results
The following result of Arterial blood gas analysis is confirmatory of Metabolic Alkalosis:
- Blood pH is elevated more than 7.45.
- Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter.
- Partial pressure of CO2 reduces to combat elevated bicarbonate.
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
- ABG
- Basic metabolic panel
- Serum aldosterone
- Serum renin
- Urine analysis, Urine pH
- Urine chloride and sodium
- Chest X-ray
- Abdominal USG/CT
- Central VBG
- Genetic Testing
Diagnostic Criteria
- The diagnosis of Metabolic Alkalosis is based on the laboratory diagnosis, which includes:
- Blood pH is elevated more than 7.45.
- Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter.
- Partial pressure of CO2 reduces to combat elevated bicarbonate.
References
- ↑ Schrauben SJ, Negoianu D, Costa C, Cohen RM, Goldfarb S, Fuchs BD, Berns JS (2018). "Accuracy of Acid-Base Diagnoses Using the Central Venous Blood Gas in the Medical Intensive Care Unit". Nephron. 139 (4): 293–298. doi:10.1159/000488501. PMC 6067967. PMID 29649820.