METABOLIC ALKALOSIS (electrolyte imbalance)

METABOLIC ALKALOSIS

  • It is a metabolic condition in which the PH of tissue is elevated beyond the normal range (7.35-7.45)
  • In chronic vomiting,
loss of water + HCL(Hypochloremia)
↓
Dehydration
↓
GFR decreased and the activation of RAAS(renin angiotensin aldosterone system)
↓ 
increase aldosterone
↓
Hypokalemic hypochloremic metabolic alkalosis


CAUSES:
  • Congenital hypertropic pyloric stenosis
  • Ca stomach
  • Healed peptic ulcer disease




TREATMENT:
  • Normal saline(0.9%) - so it is saline/chloride responsive metabolic alkalosis
  • but if still PH > 7.55 in spite of fluids give NH4CL (Ammonium chloride) 



HYPOKALEMIC METABOLIC ALKALOSIS - CHLORIDE NON RESPONSIVE METABOLIC ALKALOSIS

CAUSES : 
  • Nephrotic syndrome
  • protein losing enteropathy eg: celiac sprue
  • CHF
  • Cirrhosis
TREATMENT:
  • Spironolactone and restrict salt intake

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