Metabolic Alkalosis

Metabolic alkalosis is primary elevation of serum bicarbonate, with compensatory hypoventilation. Causes: gastric acid loss (vomiting/NG suction), loop/thiazide diuretics, hypokalemia, mineralocorticoid excess, and alkali load. Clinical: weakness, muscle cramps, hypoventilation, arrhythmias, and altered mental status. Treatment: isotonic saline and potassium repletion (chloride-responsive), stop diuretics, treat mineralocorticoid excess (chloride-resistant).

Common Symptoms

Weakness; muscle cramps; hypoventilation; arrhythmia; confusion; often asymptomatic

Causes and Pathogenesis

Gastric acid loss or renal bicarbonate retention (driven by hypokalemia/volume depletion/mineralocorticoid) raises serum bicarbonate.

Treatment

Isotonic saline + potassium chloride; stop diuretics; treat mineralocorticoid excess; acetazolamide in selected

Preventive Measures

Avoid prolonged NG suction; monitor electrolytes on diuretics; treat vomiting.

Department to Visit

It is recommended to visit the Internal Medicine department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.