alkalosis guidelines

This article serves as a quick reference for metabolic alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented.

This article serves as a quick reference for respiratory alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented.

Nearly 50 medications have been implicated as inducing hypomagnesaemia, sometimes based on insufficient data regarding clinical significance and frequency of occurrence. In fact, clinical effects attributed to hypomagnaesemia have been reported in only 17 of these drugs. A considerable amount of literature relating to individual drugs has been published, yet a comprehensive overview of this issue is not available and the hypomagnesaemic effect of a drug could be either overemphasised or under-rated. In addition, there are neither guidelines regarding treatment, prevention and monitoring of drug-induced hypomagnesaemia nor agreement as to what serum level of magnesium may actually be defined as 'hypomagnesaemia'...

Theoretically, we humans should be better adapted physiologically to the diet our ancestors were exposed to during millions of years of hominid evolution than to the diet we have been eating since the agricultural revolution a mere 10,000 years ago, and since industrialization only 200 years ago. Among the many health problems resulting from this mismatch between our genetically determined nutritional requirements and our current diet, some might be a consequence in part of the deficiency of potassium alkali salts (K-base), which are amply present in the plant foods that our ancestors ate in abundance, and the exchange of those salts for sodium chloride (NaCl), which has been incorporated copiously into the contemporary diet, which at the same time is meager in K-base-rich plant foods...

The effects of infusing a buffer solution on resuscitability and outcome was tested in patients during out-of-hospital cardiac arrest. A number (502) of adults with asystole or ventricular fibrillation with failure of first defibrillation attempt were entered into a prospective, randomized, double-blind, controlled trial. Of these, 245 patients received 250 ml of sodium bicarbonate-trometamol- phosphate mixture with buffering capacity 500 mmol/l and 257 patients received 250 ml 0.9% saline. Except for the investigational infusion, all patients were resuscitated according to international guidelines...

The technique of muscle surface pH measurement used clinically was refined for application in animal experimentation. Guidelines for electrode utilization were developed, and sources of error were investigated. In pentobarbital sodium-anesthetized rabbits, during steady-state conditions, the surface pH of the medial gastrocnemius [7.39 +/- 0.05 (SD)] was equal to that of the soleus, and both were lower than femoral venous outflow pH (7.42 +/- 0.04, P less than 0.001), which was lower than arterial pH (7.46 +/- 0...

The pathophysiology, symptomatology, and treatment of metabolic alkalosis are reviewed, with emphasis on treatment with intravenous hydrochloric acid. Three buffering systems are used by the body to correct an arterial pH above 7.45--tissue, respiratory, and renal systems. The kidneys have the primary responsibility for correcting a severe metabolic alkalosis, but several conditions (e.g., severe volume contraction) can interfere with the renal mechanisms. No unique symptoms are associated with metabolic alkalosis...

Mixed metabolic-respiratory acid-base disorders may be diagnosed when the respiratory compensation for a primary metabolic acidosis or alkalosis is inappropriate or when there is inappropriate metabolic compensation for a primary respiratory disorder. The magnitude of the primary change in HCO3 concentration (in metabolic disorders) defines the limits of compensation. We emphasized the importance of the equality of the increment in the anion gap (delta AG) and the decrement in the serum bicarbonate concentration (delta HCO3) in diagnosing a simple high AG metabolic acidosis...

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Advances in the selection and use of drugs during cardiopulmonary resuscitation (CPR) are reviewed. In 1985, the American Heart Association and the National Academy of Sciences-National Research Council revised standards and guidelines for CPR and emergency cardiac care. Algorithms were developed for treatment of (1) ventricular fibrillation and pulseless ventricular tachycardia, (2) ventricular tachycardia with pulse, (3) asystole, (4) electromechanical dissociation, (5) paroxysmal supraventricular tachycardia, (6) bradycardia, and (7) ventricular ectopy...

OBJECTIVE: To review the physiology of the chloride ion and its relationship to various disease states encountered in the ICU. Special emphasis was paid to the renal handling of chloride and its role in the evaluation of the urine and serum anion gaps. Metabolic acidosis and alkalosis are discussed. DATA SOURCES: English-language articles were identified through a search of the MEDLINE and Index Medicus databases. Bibliographies of retrieved articles were examined for relevant articles...

The analysis of both clinical findings and diagnostic procedures results were performed in 26 patients with thromboembolic pulmonary disease in order to determine the incidence of signs indicating pulmonary thromboembolism. Sudden dyspnea, hemoptysis and chest pains are the most common symptoms of the disease. These symptoms associated with radiographically confirmed pulmonary infiltrations with the elevation of hemidiaphragm and pleural effusion, particularly if they are bilateral, are the main clues for the diagnosis of pulmonary embolism...

Reviews of large series of patients with digitalis-induced arrhythmias create a seeming paradox: Hypokalemia is infrequently associated with digitalis-induced arrhythmias but the clinical benefit of supplementation of potassium for most digitalis-induced arrhythmias is obvious. Examination of the electrophysiologic abnormalities induced by digitalis coupled with the electrophysiologic effects dependent on the ratio intracellular to extracellular concentrations of potassium clarifies the issue. We present evidence that supports additive effects of the toxicity of digitalis and abnormal ratios of concentrations of potassium inside and outside the cardiac cell...