Metabolic alkalosis diagnostic study of choice

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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 [disease name]:
  • pH >7.45
  • HCO3 >26 mEq/L
  • PCO2 compensates for increased HCO3 by decreasing.

• 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:

• • pH >7.45
  • HCO3 >26 mEq/L
  • PCO2 compensates for increased HCO3 by decreasing.

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 [criteria name] criteria, which includes pH >7.45, HCO3 >26 mEq/L, PCO2 compensates for increased HCO3 by decreasing.