Metabolic alkalosis is an imbalance in the body’s acid-base system caused by factors such as fluid loss, steroid use, or overuse of antacids. Symptoms include slowed breathing, nausea, vomiting, and confusion. Treatment involves correcting the imbalance with medications and intravenous fluids. Early intervention is crucial for a good prognosis, and preventive measures include monitoring patients receiving tube or intravenous feedings and avoiding drug abuse.
Metabolic alkalosis is an imbalance in the body’s acid-base system. The term pH refers to the level of acidity or alkalinity of a substance, with a reading of 7.0 indicating neutrality. Normal body pH is slightly alkaline, with a pH range of 7.36 to 7.44. The body is designed to function optimally within this range, so when factors cause blood to become more basic than acidic, adverse effects will occur. The severity of the symptoms experienced will depend on the degree of alkalinity present within the body.
The causes of this condition may include factors that reduce the amount of body fluid. Examples include vomiting, excessive use of laxatives, or excessive urination produced by diuretic drugs. Fluid loss can cause a sharp drop in potassium and sodium levels, which produces signs of metabolic alkalosis. Other causes include steroid use or overuse of antacids or alkaline medications, such as bicarbonate.
There are several symptoms that will indicate metabolic alkalosis. One of the first symptoms of this disorder is slowed breathing. Gastrointestinal signs may include nausea, vomiting and diarrhea. Cardiovascular symptoms include a fast heart rate, irregular heart rate, and a drop in blood pressure. Confusion, irritability, and twitching may also occur. Severe alkalosis can cause seizures and coma.
The main goal of treating metabolic alkalosis is to correct the imbalance. A salt water solution and some medications will be given through an intravenous line. Agents administered may include drugs to normalize blood pressure and heart rate, along with potassium chloride to correct hypokalemia, which is a low level of potassium in the blood. Medications that relieve nausea and vomiting may also be given. Treatment of some cases may require the use of hydrochloric acid or ammonium chloride.
The prognosis of metabolic alkalosis depends on how severe the condition is and when medical intervention is initiated. If treatment is started early, the patient can make a full recovery and experience no lingering adverse effects. In cases of severe alkalosis, lack of treatment can lead to seizures, heart failure, and coma. A good prognosis also depends on the underlying factors being identified and treated, as well as addressing the presenting symptoms.
Preventive measures may include surveillance of patients receiving tube or intravenous feedings. These medical interventions have the potential to cause imbalances in fluids and minerals, such as potassium and sodium. Another preventive strategy is for patients to take care not to abuse drugs that can precipitate this condition.
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