Alkalosis

Metabolic Acidosis, Metabolic Alkalosis, Respiratory Acidosis and Respiratory Alkalosis Metabolic acidosis is closely associated with an increase in intake of protein or metabolism or an inadequate intake of alkali or accelerated loss of alkali. Metabolic acidosis is also associated with a normal anion gap. In a patient with metabolic acidosis the loss of a base or the gain of an acid decreases the bicarbonate-carbonic acid ratio and the normal pH. This is the most common acid-base disorder. Some physiologic process causes a decrease in circulating the bicarbonate, which results in a decrease in blood pH. The way the body compensates for this particular illness in through hyperventilation. The hyperventilation may not always be deep and labored because the compensation is not a “conscious one”. When we are acidic our respiratory drive is increased by mother nature (automatically). During the hyperventilation process, carbon dioxide is rapidly eliminated in the expiratory gas. In this event the remaining bicarbonate buffering capacity may be compromised as the body attempts to resist a pH change. If metabolic acidosis persists over several hours ad the kidneys are properly functioning, then the kidneys will try to help in the compensation process by releasing hydrogen and reabsorbing HCO3. In this the symptoms begin to show up in the renal system because it is not able to maintain the pH of body fluids in the normal range. In metabolic alkalosis something has led to an increase in circulating bicarbonate. This results in the raising of the pH of the blood. The way the body compensates for this is through hypoventilation. Through hypoventilation the body attempts to raise the pH. The reduced respirations allow the carbon dioxide to accumulate in body fluids. This is not good because carbon dioxide and water react together to make a carbonic acid. Metabolic alkalosis is usually caused by an excessive amount of bicarbonate or acetate. However it can also be caused by frequent usage of diuretics. Vomiting usually persists as the result of loss of hydrochloric acid. Patients with this usually are said to have an altered mental status. If metabolic alkalosis persists for several hours, in the patient with functional kidneys, the kidneys will reduce the rate of the hydrogen ion secreted in order to try and balance out the acid-base. The main thing to worry about with metabolic alkalosis is the inability to stop breathing which may cause a patient to become dangerously hypoxic while the body is trying to compensate for the alkalosis. Also, a sign to look for in this patient would be bronchiospasms. Metabolic alkalosis is a serious medical problem. In the United States alone, metabolic alkalosis is the most common acid-base disturbance observed in hospitalized patients and this accounts fifty percent of all acid-base disorders. The mortality rates