Metabolic Alkalosis and Respiratory Failure in Critically Ill Patients

Steer, Michael L.; Cloeren, Stella; Bushnell, Leonard S.; Skillman, John J.

doi:10.1097/00132586-197310000-00058

Cited by 5 publications

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“…Severe metabolic alkalosis in critically ill people can be associated with life‐threatening problems, including arrhythmias, myoclonus, and transient hypoventilation, as well as disorientation, stupor, and coma . In dogs, weakness can occur following the development of a metabolic alkalosis .…”

Section: Introductionmentioning

confidence: 99%

Incidence of hypochloremic metabolic alkalosis in dogs and cats with and without nasogastric tubes over a period of up to 36 hours in the intensive care unit

Chih¹,

Rudloff²,

Waldner

et al. 2018

J Vet Emergen Crit Care

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Section: Introductionmentioning

confidence: 99%

Incidence of hypochloremic metabolic alkalosis in dogs and cats with and without nasogastric tubes over a period of up to 36 hours in the intensive care unit

Chih¹,

Rudloff²,

Waldner

et al. 2018

J Vet Emergen Crit Care

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“…Da sich Kalium-und Wasserstoffionen intracellul/~r zu ersetzen vermSgen, kommt es bei extracellul~rer Hyperkali~mie zur metabolischen Acidose, bei extracelIul~rer Hypokali~mie zu metabolischer Alkalose. Die metabolisehe Alkalose ist bei kritisch Kranken wegen ihrer negativen Auswirkung als gravierende Komplikation aufzufassen (u. a. Bohr-Effekt I) [3,25,28].…”

Section: Komplikationen Durch Maflnahmen Der Intensivbehandlungunclassified

40. Eigenst�ndige Komplikationen der Intensivtherapie

Lawin¹

1974

Langenbecks Arch Chiv

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Anaesthesie-Abteilung des Allgemeinen Krankenhauses Altona in Hamburg Self-Inflicted Complications in Intensive TherapySummary. Typical complications in intensive care may result from technical causes, human failure, and complication of a serious basic disease, as well as from the actual intensive treatment. Allergic reactions, toxic organic lesion and diarrhea can be induced by bacterial infection after prolonged intubation, tracheostomy, long-term artificial respiration, treatment with aerosols, venous and bladder catheters and wide-spectrum antibiotics. Parenteral nutrition may lead up to hypertonic and hypotonic hyperhydratation, fluid overloading, septicemia and insufficient caloric supply. Hypocalemia and metabolic alkalosis are other severe complications. After massive transfusions the risk of impaired metabolism and coagulation, and even of the occurrence of hepatitis exists. Aggressive polypragmasy can cause a psychotic syndrome and in some cases even delirium.

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“…7 On the other hand, it has been observed that alkalinisation of the blood is often accompanied by an increase in the alveolararterial oxygen gradient, 8 with a reduced PaO 2 , 9 while HClinduced metabolic acidosis increments the PaO 2 . 10 These data seem to suggest the advisability of treating metabolic alkalosis in the liver transplant recipient.…”

Section: Introductionmentioning

confidence: 99%

Metabolic alkalosis following orthotopic liver transplantation

Peral

Gómez-Arnau

Valle

et al. 1995

Clinical Intensive Care

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Objective:To determine the incidence, causative factors and impact of post-operative metabolic alkalosis in liver transplant recipients. Design: Retrospective.Setting: Post-operative intensive care unit. Subjects: Eighty adult liver transplant recipients.Interventions: Arterial blood gases were assessed on postoperative days one, two and three.Endpoints: Metabolic alkalosis was defined as the presence of a standard bicarbonate level ≥ ≥ ≥ ≥ ≥26 mEq/l in one or more determinations. Measurements and main results: Sixty-five patients (81%) developed post-operative metabolic alkalosis (Group 1). They had required a greater transfusion of intraoperative blood (28±22 units versus 14±10 units; p<0.01) and fresh frozen plasma (38.5±27.4 units versus 17.3±7.8 units; p<0.01) than the 15 patients without metabolic alkalosis (Group 2). There were no differences in the intraoperative infusion of sodium bicarbonate, type of fluids employed to restore blood volume, type of graft preservation solution, degree of preoperative liver insufficiency, post-operative fluid balance, gastric aspirate or graft function. This suggests that these factors are not associated with metabolic alkalosis. The PaO 2 and PaCO 2 values at extubation were similar in the two groups. There was no significant difference in the duration of mechanical ventilation (32±20 hours in Group 1 versus 34±16 hours in Group 2), in 6hour post-extubation PaCO 2 values (5.2±0.6 kPa [40.2±4.8 mmHg] in Group 1 versus 5.3±0.6kPa [40.7±4.3 mmHg] in Group 2), or in 30-day survival (74% in Group 1 versus 82% in Group 2). Conclusions: Metabolic alkalosis is a common finding inKey words: Blood transfusionImmediate post-operative period Liver transplantation Metabolic alkalosisStandard bicarbonate the first 72 hours after liver transplantation and is related to increased blood transfusion. Since it does not induce consequential hypoventilation or prolong the duration of mechanical ventilation, its treatment is not usually justified.

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Metabolic Alkalosis and Respiratory Failure in Critically Ill Patients

Cited by 5 publications

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Incidence of hypochloremic metabolic alkalosis in dogs and cats with and without nasogastric tubes over a period of up to 36 hours in the intensive care unit

Incidence of hypochloremic metabolic alkalosis in dogs and cats with and without nasogastric tubes over a period of up to 36 hours in the intensive care unit

40. Eigenst�ndige Komplikationen der Intensivtherapie

Metabolic alkalosis following orthotopic liver transplantation

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