How can prolonged vomiting affect the pH?
Expelling the gastric acid contents causes the loss of chloride and hydrogen ions which can lead to hypochloremic metabolic alkalosis, where there are high levels of bicarbonate and carbon dioxide but low levels of chloride, leading to an increased blood pH.
What electrolytes are lost during vomiting?
Electrolytes and acid-base disorders The vomiting of gastric or intestinal contents most commonly involves the loss of fluid that contains chloride, potassium, sodium, and bicarbonate. The sequelae of these losses include dehydration along with hyponatremia, hypochloremia, and hypokalemia.
What can excessive vomiting lead to?
Continued vomiting may cause severe dehydration that can be life-threatening. Call your doctor if you or your child is showing symptoms of dehydration, such as: Excess thirst or dry mouth.
What does vomiting do to electrolytes?
Vomiting and diarrhea are other causes of electrolyte imbalances, as they result in excessive fluid loss. You must replenish these fluids and electrolytes in order to prevent dehydration, a potentially life-threatening condition.
Does vomiting cause alkalosis or acidosis?
Vomiting or nasogastric (NG) suction generates metabolic alkalosis by the loss of gastric secretions, which are rich in hydrochloric acid (HCl).
Does excessive vomiting cause metabolic alkalosis?
People who experience severe bouts of vomiting can get metabolic alkalosis. It’s also common in people who are critically ill or in the hospital for certain conditions. The risk is especially high if you are dehydrated or need your stomach pumped (gastric suctioning).
Is alkalosis high or low pH?
The pH of your blood should be around 7.4. Acidosis is characterized by a pH of 7.35 or lower. Alkalosis is characterized by a pH level of 7.45 or higher.
What is Hypochloremic metabolic alkalosis?
Hypochloremic alkalosis results from either low chloride intake or excessive chloride wasting. Whereas low chloride intake is very uncommon, excessive chloride wasting often occurs in hospitalized children, usually as a result of diuretic therapy or nasogastric tube suctioning.
What does vomiting induced metabolic alkalosis cause?
Severe vomiting also causes loss of potassium (hypokalemia) and sodium (hyponatremia). The kidneys compensate for these losses by retaining sodium in the collecting ducts at the expense of hydrogen ions (sparing sodium/potassium pumps to prevent further loss of potassium), leading to metabolic alkalosis.
Does alkalosis cause hypokalemia?
Acid-base balance and potassium disorders are often clinically linked. Importantly, acid-base disorders alter potassium transport. In general, acidosis causes decreased K(+) secretion and increased reabsorption in the collecting duct. Alkalosis has the opposite effects, often leading to hypokalemia.
Which IV fluid is best for vomiting?
Overall, i.v. fluids help correct dehydration and improve symptoms, dextrose saline may be more effective at reducing nausea than normal saline. (The lower concentration of sodium in dextrose saline may exacerbate any pre-existing hyponatraemia.
How does vomiting cause metabolic alkalosis?
Vomiting or nasogastric (NG) suction generates metabolic alkalosis by the loss of gastric secretions, which are rich in hydrochloric acid (HCl). Whenever a hydrogen ion is excreted, a bicarbonate ion is gained in the extracellular space.
What is hypochloremic alkalosis?
Hypochloremia is defined as a serum chloride level of less than 95 mEq/L. Hypochloremic alkalosis results from either low chloride intake or excessive chloride wasting.
How is hypochloremic metabolic alkalosis repaired in diabetic ketoacidosis?
Hypochloremic metabolic alkalosis is repaired by chloride repletion. In circumstances that are not responsive to traditional chloride rich fluids, an infusion of hydrochloric acid can be considered to both reduce serum pH and increase serum chloride.
What is hypochloremia?
Hypochloremia is defined as a serum chloride level of less than 95 mEq/L. Hypochloremia results from either low chloride intake or excessive chloride wasting. Low chloride intake is very uncommon. Excessive chloride wasting often occurs in hospitalized children, usually as a consequence of diuretic therapy or nasogastric tube suctioning.
What is the pathogenesis of metabolic alkalosis?
In the pathogenesis of metabolic alkalosis, the primary abnormality occurs via 2 mechanisms [1,2,3] Increased plasma bicarbonate concentration due to hydrogen loss in the urine or gastrointestinal tract, hydrogen movement into the cells, the administration of bicarbonate, or volume contraction.