Metabolic alkalosis (patient information)

Template:Metabolic alkalosis (patient information)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marufa Marium, M.B.B.S[2]

Overview

The normal physiological pH of blood is 7.35 to 7.45. An increase above this range is known to be Alkalosis. Metabolic Alkalosis is defined as a disease state where blood pH is more than 7.45 due to secondary metabolic processes.

What are the symptoms of Metabolic alkalosis?

Patients suffering from Metabolic alkalosis usually appear restless, irritable. Patients with metabolic alkalosis is usually remarkable for tachycardia/dysrhythmia, Hypoxemia, Compensatory hypoventilation, Muscle cramps, Tremor,tingling and numbness in extremities, Weakness on clinical examination.

What causes Metabolic alkalosis?

Causes of Metabolic Alkalosis are Vomiting, Diarrhea, Diuretics, Cystic Fibrosis, Primary Hyperaldosteronism, Secondary hyperaldosteronism, laxative use, CKD, electrolyte and nutritional imbalances, Milk-alkali syndrome, Blood transfusion, Genetic diseases for instances Bartter, Liddle, Gitelman syndrome etc. Among them, life threatening causes are loss of gastric acid, excessive use of loop and thiazide diuretics.

Who is at highest risk?

Common risk factors in the development of Metabolic Alkalosis include Vomiting, Milk-alkali syndrome, Severe hypokalemia, Primary hyperaldosterinism, Cushing syndrome, Diuretics use and genetic disease for instances- Bartter and gitelman Disease.

Diagnosis

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.

When to seek urgent medical care?

When a individual is feeling restless, irritable. Patients with metabolic alkalosis is usually remarkable for tachycardia/dysrhythmia, hypoxemia, Hypoxemia, Compensatory hypoventilation, Muscle cramps, Tremor, tingling and numbness in extremities, Weakness on clinical examination.

Treatment options

• Medical Therapy:

Supportive therapy for Metabolic alkalosis includes volume repletion, electrolyte repletion, removal of inducing source and after stabilizing patient treatment according to etiology. Pharmacologic medical therapy is recommended among patients with electrolyte imbalances, hypervolemia, loss of GI hydrogen.

• Surgery:

The mainstay of treatment for metabolic alkalosis is medical therapy. Surgery is usually reserved for patients with either pyloric stenosis), Zollinger-ellison syndrome,Villous adenoma, Conn syndrome or adrenL adenoma/ hyperplasia /carcinoma, Reno vascular hypertension, juxtaglomerular cell(renin producing) tumor, renal cell carcinoma, hemangiopericytoma, nephroblastoma.

Where to find medical care for Metabolic alkalosis?

To any healthcare provider.

What to expect (Outlook/Prognosis)?

Early stabilization of patient is associated with the most favorable prognosis.

Possible complications

Common complications of Metabolic alkalosis include: Electrolyte imbalances: hypokalemia, hypomagnesaemia, hypophosphatemia Coronary arterial blood flow reduction leading to angina, refractory arrhythmia Anaerobic glycolysis Reduced ventilation leading to low arterial oxygen saturation, increased CO2 Decreased blood flow to cerebral arteries leading to altered mental status, lethargy, tetany, delirium, seizure.