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Metabolic alcalosis

Zoran Igrutinović, Amira Peco-Antić, Nedeljko Radlović, Biljana Vuletić, Slavica Marković, Ana Vujić, Zorica Rasković
INTRODUCTION: Pseudo-Bartter syndrome encompasses a heterogenous group of disorders similar to Bartter syndrome. We are presenting an infant with pseudo-Bartter syndrome caused by congenital chloride diarrhoea. CASE OUTLINE: A male newborn born in the 37th gestational week (GW) to young healthy and non-consanguineous parents. In the 35th GW a polyhydramnios with bowel dilatation was verified by ultrasonography. After birth he manifested several episodes of hyponatremic dehydration with hypochloraemia, hypokalaemia and metabolic alkalosis, so as Bartter syndrome was suspected treatment with indomethacin, spironolactone and additional intake of NaCl was initiated...
September 2011: Srpski Arhiv za Celokupno Lekarstvo
Marie-Pierre Otto, Valérie Cheminel, Lionel Crevon, Laurence Dubourg, Aoumeur Hadj-Aissa, Chantal Mounier, Jean-Michel Prevosto
We report the case of an asymptomatic patient presenting a severe chronic renal hypokalaemia. Once being sure of no diuretics use, two hypothesis can be mentioned for a normotensive patient presenting an hypokalaemia associated with a metabolic alcalosis: Bartter syndrome or Gitelman syndrome. The highlighting of low magnesaemia and hypocalciuria strongly concentrates the diagnosis on Gitelman syndrome. First, this has been strengthened by the results of renal function tests and later it has confirmed by molecular diagnosis with the identification of a known homozygous mutation on SLC12A3 gene...
July 2011: Annales de Biologie Clinique
F Neffati, I Hellara, M A Jelizi, J Bahri, W Douki, A Ben Amor, M F Najjar
We report the case of a 54-year-old man, without particular pathological antecedents admitted to the emergency of the university hospital of Monastir, for right renal colic. Radiography of the urinary tract without preparation and renal echography showed bilateral renal lithiasis and a right ureteral lithiasis. The interrogation revealed concept of vomiting after which the patient felt relieved. The biological assessment objectified an hypochloremic metabolic alcalosis, an increase in the anion gap, a severe impaired renal function of obstructive origin and an hypokaliemia...
July 2009: Annales de Biologie Clinique
Daniela Urich, Humberto Trejo, Alejandro Pezzulo, Juan Carlos Caraballo, Jeydith Gutiérrez, Ignacio Castro, Roberto Sánchez-de León
Hypocapnia/alkalosis is a consequence of several lung and metabolic pathologies. The aim of this study was to determine whether the increase of fluid filtration rate (FFR) that occurs during Hypocapnia/alkalosis circumstances is determined by hypocapnia, alkalosis or both. 7 groups were formed (N=36) using isolated rabbit lungs. Group 1: Control (PCO2 6%, pH: 7.35-7.45); Group 2 (n=6): Hypocapnia/Alkalosis (CO2 1%, pH: 7.9); Group 3 (n=6): Hypocapnia/Normo-pH (CO2 1% pH 7.35-7.45), Group 4 (n=6) Normocapnia/Alcalosis (CO2 6%, pH: 7...
June 2008: Investigación Clínica
Jean-Michel Achard, Juliette Hadchouel, Sébastien Faure, Xavier Jeunemaitre
Several familial forms of hypertension have been identified, in which the mendelian pattern of inheritance indicated that hypertension results from the alteration of a single gene. This short review focuses on those rare monogenic disorders characterized by a low-renin profile. This common feature reflects that the causative mutations responsible for these disorders all result in an excessive sodium reabsorption in the aldosterone-dependent nephron. Low-renin familial hypertensions with hypokalemia encompass familial hyperaldosteronisms, in which aldosterone levels are elevated, and familial pseudohyperaldosteronisms, mimicking aldosteronism despite appropriately suppressed aldosterone levels...
April 2006: Advances in Chronic Kidney Disease
M Rehm, P F Conzen, K Peter, U Finsterer
About twenty years ago, Peter Stewart had already published his modern quantitative approach to acid-base chemistry. According to his interpretations, the traditional concepts of the mechanisms behind the changes in acid-base balance are considerably questionable. The main physicochemical principle which must be accomplished in body fluids, is the rule of electroneutrality. There are 3 components in biological fluids which are subject to this principle: a)Water, which is only in minor parts dissociated into H+ and OH-, b)"strong", i...
April 2004: Der Anaesthesist
V A Hryshchenko
The modelling of metabolic acidosis and alcalosis states proves that AAB is capable to influence on the haemoglobin parameters and its oxiform levels in the blood of newborn animals. The quantitative redistribution of the indicated haemoglobin forms in blood of the experimental animal is estimated as compensator process and is explained by their buffer properties. The investigated regularities revealed some aspects of adaptive mechanisms manifested during the abnormal exit of the newborn organism from the respiratory-metabolic acidosis state...
September 1999: Ukraïnsʹkyĭ Biokhimichnyĭ Z︠h︡urnal
W Schmidt, N Maassen
The knowledge about metabolism and muscular fatigue has been considerably improved during the recent years. Intramuscular pH should not generally be discussed as a factor of cellular fatigue as it has been shown to increase transiently at the beginning and to be very differently affected in ST-(6,9) and FT-fibers (6,2) at the end of exercise. During maximum exercise, we assume changes of muscle membrane potential due to increasing interstitial potassium concentrations as an important performance-limiting factor...
1998: Wiener Medizinische Wochenschrift
J Zimmermann, M Reincke, L Schramm, J Harlos, B Allolio
BACKGROUND: Hypokalemia due to renal potassium wasting in the absence of hypertension, moderate metabolic alkalosis, hyperreninism and hyperaldosteronism suggest the presence of Bartter's syndrome. The underlying cause is an inherited defect of sodium chloride reabsorption in the thick ascending limb of Henle. A differential diagnosis of Bartter's syndrome is Gitelman's syndrome, another hypokalemia-hypomagnesemia syndrome, which is thought to be caused by a transport defect in the distal tube...
December 15, 1994: Medizinische Klinik
R Hürlimann, M Enzler, R O Binswanger, C Meyenberger
A 62 year old woman presented with the symptoms of a gastric outlet obstruction together with severe metabolic hypochloremic alcalosis. A gallstone in the duodenum with gastric outlet obstruction was diagnosed by abdominal ultrasonography. In a one-stage surgical procedure, cholecystectomy, enterolithotomy and repair of the cholecytoduodenal fistula were performed. The postoperative course was uneventful. Pathogenesis, clinical findings, diagnostic procedures and therapeutic options of gastric outlet obstruction secondary to a gallstone impacted in the duodenal bulb (Bouveret's Syndrome) are discussed...
August 1995: Zeitschrift Für Gastroenterologie
I Nakao, T Ito, N Kasai
In outlining the pathology of various electrolyte metabolism abnormalities in cancer patients we considered the main clinical points between pathologies and emergency treatment. In regard to sodium (Na+) metabolism, one pathologic state that requires our attention is hypernatremia. Hypernatremia is accompanied with dehydration and is due to water loss, vomiting, diarrhea and renal insufficiency. One of the major causes of this condition is lack of the antidiuretic hormone due to intracranial metastasis of the tumor...
February 1983: Gan to Kagaku Ryoho. Cancer & Chemotherapy
V I Bragin, E N Danilov, G A Rusanov, N A Shcherbakha, V I Aleksandrov
The oxygen-transport function of blood in hyperoxia and acute disturbances of the acid-alkali condition was studied in "oxygenator--desoxygenator" as a model. It has been established that in acidosis there occurs decreased intensity of glycolysis in erythrocytes, accumulation of 2,3 diphosphoglyceric acid which decreases affinity of hemoglobin for oxygen. It does not occur in alcalosis.
January 1980: Vestnik Khirurgii Imeni I. I. Grekova
M Demi, G Meneghetti
The treatment of neonatal respiratory distress associates the improvement of lung ventilation with the correction of acid-base equilibrium (metabolic acidosis). In such a context we have considered 10 newborns with respiratory distress and we monitored pH, PCO2, B.E. and standard bicarbonate in capillary blood at 1, 5, 10, 25 hours after birth. The sodium bicarbonate doses given as a result of the emogasanalisis are above those usually recommended. We then give suggestions on how to use the sodium bicarbonate required to correct the acidosis without the aid of an emogasanaliser in order to avoid the iatrogenic alcalosis danger...
May 1982: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
K Linko, I Saxelin
The effect of blood transfusions on the electrolyte, metabolic and hemodynamic status of 31 patients undergoing major laparotomies was studied. Two groups were compared: Group I, 11 patients receiving continuous intraoperative blood transfusions exceeding 5 units at a rate over 0.3 ml/kg/min, and Group II, 20 patients receiving transfusions of 1-5 units at a rate below the limit. Transiently increased potassium values (5.2 +/- 0.3 mmol/l) were found in Group I during the rapid transfusion phase. The difference was statistically significant (P less than 0...
February 1986: Acta Anaesthesiologica Scandinavica
H Hochreutener, J Issakainen, C Bachmann, K Baerlocher
Carbamyl phosphate synthetase (CPS) catalyses the synthesis of carbamyl-phosphate from ammonia and bicarbonate and is the first step in ureagenesis. The infant described in this report suffered from deficiency of this enzyme. The symptoms started on the 2nd day of life with tachycardia, apathy, irritability and metabolic alcalosis, on the 4th day coma and fits occurred due to hyperammonia (ammonia in the blood max 496 mumol/l, normally up to 150 in newborns). In hepatic tissue no activity of carbamyl phosphate synthetase could be measured (normal range 0...
June 1989: Helvetica Paediatrica Acta
U Gottstein, U Zahn, K Held, F H Gabriel, T Textor, W Berghoff
CBF decreases when arterial PCO2 is lowered by physiological, pathological or therapeutically induced hyperventilation. This is accompanied by an undelayed compensatory increase of oxygen-av-differences. Continuous monitoring of enzymatically determined glucose-av-differences of the brain during hyperventilation has for the first time shown that there is an undelayed fall of the cerebral venous glucose content, too. This indicates that the brain cells extract an augmented amount of glucose per ml blood during decreased CBF...
April 15, 1976: Klinische Wochenschrift
H D Seitz
The sign of a traumatically caused alveolar hyperventilation in severe cranio-cerebral injury is a respiratory alcalosis as well as hypoxia and hypoxemia in the arterial as well in the cerebral veneous blood. The combination of decreased oxygen tension or saturation and hypocapnia can exist for several days and in a lethal course transform into a combined metabolic respiratory acidosis with increasing carbonic acid tension and so initiate the prefinal state. The extremely pathological blood gases are usually the first sign of shock-specific changes of the lung...
December 16, 1976: Fortschritte der Medizin
W Waldhäusl
Mineralocorticoids are out of the causes of secondary hypertension. Excess production of mineralocorticoids induces sodium and fluid retention, loss of potassium and metabolic alcalosis. The diagnosis of mineralocorticoid syndromes depends on the interpretation of the functional status of the renin-mineralocorticoid-system, which is in part responsible for the maintenance of normal blood pressure. The classical representative of this group is the syndrome of primary aldosteronism. Causes of mineralocorticoid syndromes associated with hypertension are: 1...
August 26, 1976: Fortschritte der Medizin
K D Bock, W Cremer, U Werner
Description of 23 patients (21 women, 2 men) with an average age of 36.6 (19--68) years, who were hypokalemic during 6.5 years on the average (range 1/2--16 years). The cause of the potassium depletion was malnutrition (anorexia nervosa, vomiting) and/or abuse of laxatives and/or diuretics. With increasing duration of potassium depletion renal function deteriorated; in two cases terminal renal failure developed. Histology of the kidneys (9 cases) showed the picture of chronic abacterial interstitial nephritis...
1978: Klinische Wochenschrift
K Strasser, P Harnacke, H Albrecht, J Morgenstern, H Schmidt
Comparison of 650 deliveries with P.A. and of 928 deliveries without P.A. during the same period. PH from the umbilical artery and 1 minute Apgar score were studied in three groups of patients: 1.) All deliveries, 2.) Spontaneous vaginal deliveries without maternal or fetal risk, 3.) Operative vaginal deliveries. The only significant differences were found among the operative vaginal deliveries: The infants of the peridural group showed a higher incidence of pH-values above 7,2 than those of the non peridural group...
June 1975: Zeitschrift Für Geburtshilfe und Perinatologie
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