What causes hypochloremic Hypokalemic metabolic alkalosis?

Hypochloremia is usually caused by excess use of loop diuretics, nasogastric suction, or vomiting. Metabolic alkalosis is usually present with hypochloremia. Vomiting causes loss of hydrochloric acid.

What causes combined respiratory and metabolic alkalosis?

Too much acid and too little base in the blood causes an acidotic pH level, and the result is combined respiratory and metabolic acidosis. For combined respiratory and metabolic alkalosis, the PaCO2 level is decreased and the HCO3 level is elevated. Too little acid and too much base cause alkalosis (see Table 2).

How do you correct hypochloremic Hypokalemic metabolic alkalosis?

Replacement of electrolytes with chloride salts is the most important mode of therapy for hypochloremic alkalosis. A full nutritional assessment should be obtained, energy intake calculated, and adequate energy intake ensured through oral or nasogastric methods.

Can you have both respiratory and metabolic alkalosis at the same time?

You can also NOT have a primary respiratory disorder and a compensatory respiratory response at the same time. But you can have a primary metabolic acidosis (e.g. accumulation of lactic acid) and a primary metabolic alkalosis (vomiting gastric HCl) at the same time.

Does respiratory alkalosis cause hypokalemia?

Persistent respiratory alkalosis can induce secondary hypocalcemia and hypokalemia that may cause cardiac arrhythmias, conduction abnormalities, and various somatic symptoms such as paresthesia, hyperreflexia, convulsive disorders, muscle spasm and tetany [2].

How does hypercalcemia cause metabolic alkalosis?

Hypercalcemia may cause metabolic alkalosis by volume depletion and enhanced bicarbonate reabsorption in the proximal tubule. However, hypercalcemia from primary hyperparathyroidism is usually associated with a metabolic acidosis.

How does diuretic cause metabolic alkalosis?

The generation of a metabolic alkalosis with diuretic therapy is primarily due to contraction of the extracellular fluid space caused by urinary losses of a relatively HCO3 -free fluid.

How do respiratory and metabolic alkalosis differ?

Use pH to determine Acidosis or Alkalosis. ph. < 7.35. 7.35-7.45.

Can metabolic acidosis lead to respiratory alkalosis?

Respiratory alkalosis may occur during recovery from metabolic acidosis because hyperventilation (the compensation for metabolic acidosis) persists for 24 to 48 hours after correction of the acidosis. These patients are sometimes hypoxemic.

Why respiratory alkalosis causes hypocalcemia?

HVS was thought to be the main cause of hypocalcemia as intraoperative ABGA showed severe respiratory alkalosis. Alkalosis promotes the binding of calcium to albumin and can reduce the fraction of ionized calcium in the blood, and ionized calcium may reduce without changes in total calcium.

How does hypokalemia cause metabolic alkalosis?

Second, hypokalemia stimulates the apical H+/K+ ATPase in the collecting duct. Increased activity of this ATPase leads to teleologically appropriate potassium ion reabsorption but a corresponding hydrogen ion secretion. This leads to a net gain of bicarbonate, maintaining systemic alkalosis.

What diuretic causes metabolic alkalosis and hypokalemia?

Loop agents and distal convoluted tubule agents, such as the thiazides, produce hypokalemic, hypochloremic, metabolic alkalosis that responds to potassium chloride replacement. Carbonic anhydrase inhibitors produce less hypokalemia and volume depletion but commonly induce metabolic acidosis that is often symptomatic.

What is hypochloremic metabolic alkalosis?

FINAL DIAGNOSIS HYPOCHLOREMIC METABOLIC ALKALOSIS. I. INTRODUCTION Metabolic alkalosis is an acid-base disorder in which the pH of the blood is elevated beyond the normal range of 7.35-7.45.

What is the pathophysiology of hypochloremia?

Hypochloremia is usually caused by excess use of loop diuretics, nasogastric suction, or vomiting. Metabolic alkalosis is usually present with hypochloremia. Vomiting causes loss of hydrochloric acid. In the presence of ECF volume contraction, there is an increase in Na and HCO3− resorption in the kidney, which helps to maintain the alkalosis.

How is hypochloremia diagnosed in diabetic ketoacidosis?

The diagnosis of hypochloremia is made based on the patient’s history of diuretic therapy, vomiting, or nasogastric suctioning along with the assessment of chloride values in the presence of metabolic alkalosis. If urine chloride is less than 10 mEq/L, then hypochloremia is due to chloride responsive alkalosis.

Is hypochloremia associated with anion gap acidosis?

In theory, therefore, the finding of hypochloremia in conjunction with an anion gap acidosis should evidence a coexisting metabolic alkalosis. In the clinical setting, however, hypochloremia is occasionally found in patients with anion gap acidosis but without exposure to a recognized alkalosis-inducing process.