endocrine and metabolic disorders
Metabolic Alkalosis
Treatment of Metabolic Alkalosis
Cause treated IV 0.9% saline solution for chloride-responsive metabolic alkalosis Underlying conditions are treated, with particular attention paid to correction of hypovolemia and hypokalemia. Patients with chloride-responsive metabolic alkalosis are given 0.9% saline solution IV; infusion rate is typically 50 to 100 mL/hour greater than urinary and other sensible and insensible fluid losses until urinary Cl rises to>25 mEq/L (> 25 mmol/L) and urinary pH normalizes after an initial rise from bicarbonaturia. Patients with chloride-unresponsive metabolic alkalosis rarely benefit from rehydration alone. 7.6) sometimes require more urgent correction of blood pH. Hemofiltration or Hemodialysis is an option, particularly if volume overload and renal dysfunction are present. In patients with severe metabolic alkalosis (pH > 7.6) and kidney failure who otherwise cannot or should not undergo dialysis, hydrochloric acid in a 0.1 to 0.2 normal solution IV is safe and effective but must be given through a central catheter because it is hyperosmotic and scleroses peripheral veins. Dosage is 0.1 to 0.2 mmol/kg/hour. Frequent monitoring of ABGs and electrolytes is needed. 