Affiliation:
1. Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus and The Ohio State University College of Medicine, Columbus, OH, USA
Abstract
Metabolic alkalosis is characterized by the primary elevation of the serum bicarbonate concentration with a normal or elevated partial pressure of carbon dioxide. Although there may be several potential etiologies in the critically ill patient in the pediatric or cardiothoracic intensive care unit, metabolic alkalosis most commonly results from diuretic therapy with chloride loss. In most cases, the etiology can be determined by a review of the patient’s history and medication record. Although generally innocuous with limited impact on physiologic function, metabolic alkalosis may impair central control of ventilation, especially when weaning from mechanical ventilation. The following manuscript presents the normal homeostatic mechanisms that control pH, reviews the etiology of metabolic alkalosis, and outlines the differential diagnosis. Options and alternatives for treatment including pharmacologic interventions are presented with a focus on these conditions as they pertain to the patient in the pediatric or cardiac intensive care unit.
Subject
Cardiology and Cardiovascular Medicine,General Medicine,Pediatrics, Perinatology and Child Health,Surgery
Cited by
2 articles.
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1. Postoperative Renal Management, Fluid/Electrolyte Management and Acid–Base Disorders;Congenital Heart Disease in Pediatric and Adult Patients;2023
2. Metabolic Alkalosis;Nephrology Self-Assessment Program;2022-01