Alkalosis: The Health Implications Of Acid-Base Balance Disturbance To The Physiological Make Up Of Man

Funom Makama By Funom Makama, 21st Mar 2014 | Follow this author | RSS Feed
Posted in Wikinut>Health>General Health>Diseases & Infections

The condition is which bases are added or acids are removed from the system are called alkalosis. Elevation of pH above 7.4 is called alkalemia. Alkalosis may be metabolic or respiratory in origin.

Metabolic Alkalosis

The following are the major causes of metabolic alkalosis:
1. Poisoning by alkalies, therapeutic administration of large doses of alkali or chronic intake of excess of absorbable antacids;
2. Loss of gastric juice, prolonged vomiting or aspiration;
3. Excessive diuretic therapy which leads to alkalosis, hypochloremia and hypokalemia;
4. Cushing’s syndrome and primary aldosteronism; and
5. Cushing’s syndrome and primary aldosternonism; and
6. Hypokalemic alkalosis.

The mechanisms of alkalosis vary in the different conditions. During fluid loss from the stomach and kidneys, there is loss of chloride in addition to volume depletion. The latter causes reduction in glomerular filtration and this impaired the elimination of bicarbonate by the Kidney. In the management of this type of alkalosis, correction of extracellular volume is important. The mechanism of acidosis in hyperadrenocorticism is not clearly known. In hypokalemia H+ shifts into the intracellular compartment. In addition, the renal loss of H+ is also increased and these lead to alkalosis.

Clinical Representations And Treatment

Clinical features and diagnosis: The clinical features of the underlying condition are evident. In addition, alkalosis leads to neuromuscular irritability and tetany. Irritability, apathy, confusion and stupor may appear as the condition progresses. Plasma bicarbonate is increased and chloride is low. There is mild increase in PCO2 which is a compensatory phenomenon.

Treatment: Mild alkalosis does not require any specific therapy. When severe losses of gastric juice occurs, intravenous 0.85% saline is the ideal replacement fluid for correcting alkalosis and volume depletion. Potassium should also be supplemented. Diuretic-induced alkalosis responds to potassium chloride and temporary withdrawal of the diuretic. The alkalosis of hypokalemia is corrected by potassium supplementation. In hyperadrenocorticism, attention should be given to correct the endocrine abnormality.

Respiratory Alkalosis

This is due to excessive removal of CO2 by hyperventilation. Common causes include hyperventilation occurring in anxiety or hysteria, fever, septicemia, exercise and faulty ventilator assistance. Central nervous system lesions like head injuries, tumours, vascular lesions, encephalitis, chronic hepatic failure and chronic low grade hypoxic states lead to sustained chronic loss of CO2.

Clinical features and diagnosis: In all cases, features of the underlying disorder may be evident. Alkalosis resulting from acute hyperventilation gives rise to paraesthesia, numbness, giddiness and tetany. Severe alkalosis leads to confusion or stupor.
Diagnosis can be made from the clinical picture, where hyperventilation is obvious. Laboratory findings include raised pH and lowered levels of plasma bicarbonate and this distinguishes the condition from metabolic acidosis in which both pH and bicarbonate are lowered.

Treatment: It is directed towards the underlying disorder. Sedation and reassurance may serve to stop hyperventilation in hysterical individuals. Dramatic relief can be obstained by rebreathing exhaled air which helps to increase the CO2 content of inspired air and this increase the PCO2.

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3. Diseases Of The Myocardium II: Cardiomyopathy
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author avatar Lambasted
25th Mar 2014 (#)

As usual, one of your excellent stuff you have shown to us.. Keep it up Dr. Funom

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