Metabolic alkalosis is an imbalance in the body's acid-base system. The term pH refers to the level of acidity or alkalinity of a substance, with a reading of 7.0 indicating neutrality. Normal body pH is slightly alkaline, with a pH range of 7.36 to 7.44. The body is designed to function optimally within this range, so when factors cause the blood to become more base than acid, adverse effects will occur. The severity of the symptoms manifested will be dependent upon the degree of alkalinity present within the body.
Causes of this condition may include factors which lessen the amount of body fluid. Examples include vomiting, the overuse of laxatives, or excessive urination produced by diuretic medications. The loss of fluids can cause potassium and sodium levels to sharply decline, which produces signs of metabolic alkalosis. Other causes include the use of steroids, or the overuse of antacids or alkaline drugs, such as bicarbonate.
There are several symptoms that will indicate metabolic alkalosis. One of the first symptoms of this disorder is slowed breathing. Gastrointestinal signs may include nausea, vomiting, and diarrhea. Cardiovascular symptoms involve a fast heart rate, irregular heart rate, and a drop in blood pressure. Confusion, irritability, and twitching may also be manifested. Severe alkalosis can cause convulsions and a coma.
The main aim of treatment for metabolic alkalosis is to rectify the imbalance. A salt water solution and certain medications will be given through an intravenous line. Administered agents may include drugs to normalize blood pressure and heart rate, along with potassium chloride to correct the hypokalemia, which is low blood potassium. Drugs that provide relief of nausea and vomiting may also be given. Treatment of some cases may necessitate the use of hydrochloric acid or ammonium chloride.
The prognosis of metabolic alkalosis depends on the level of severity of the condition and when medical intervention is initiated. If treatment is started early, the patient may completely recover and not experience lingering adverse effects. In cases of severe alkalosis, the lack of treatment can result in convulsions, heart failure, and coma. A good prognosis is also dependent upon the underlying factors being identified and treated, as well as addressing the presenting symptoms.
Preventive measures may include watching patients who are receiving tube feedings or intravenous feedings. These medical interventions have the potential to cause imbalances in fluids and minerals, such as potassium and sodium. Another preventive strategy is for patients to take care not to overuse drugs which may precipitate this condition.