Alkalosis - what is it? What to do?
The acid-base balance of the blood reflects the nature of metabolic processes in the body. In the room, the pH of the blood should remain at around 7.35-7.45. This value reflects the content of acidic and alkaline blood components.
Alkalosis is a violation of the acid-base balance of the blood with an increase in the pH level against the background of an increase in alkalis. The reasons for this failure can be very diverse. The increase can be absolute and relative, compensated and decompensated.
If a person does not work in the field of medicine, then with such a concept as alkalosis he can only come across at a doctor's appointment, when making a diagnosis. Alkalosis can affect the health and well-being of the patient, seriously disrupting it. Sometimes alkalosis even becomes the cause of death. Therefore, it must be diagnosed and treated in a timely manner.
The growth of alkalis in the blood leads to an increase in its pH, while the amount of hydrogen ions in it decreases. In this case, doctors talk about alkalizing the internal environment of the body. If, on the contrary, an increase in the amount of acids and hydrogen ions is observed in the blood, then the pH drops. In this case, the patient's diagnosis will sound like acidosis. This condition is the complete opposite of alkalosis.
A jump in pH occurs when acid begins to be excreted in excess from the stomach, while there is a loss of hydrogen ions in the urine and CO2 in the exhaled air. Symptoms of this disorder occur even when the deviations from the norm are minimal. If the shift in the acid-base balance of the blood is serious, then the person needs emergency medical care with his placement in the intensive care unit.
- Causes and pathogenesis of alkalosis
- Alkalosis symptoms
- Alkalosis in a child
- Diagnosis and treatment of alkalosis
Causes and pathogenesis of alkalosis
Various reasons can lead to alkalosis, including:
Encephalitis with inflammation of the brain structures.
- Tumors of the central nervous system.
- Stimulating the work of the respiratory center with the help of medications and toxins.
- Treatment of neuroses and hysteria, accompanied by hyperventilation.
- High body temperature with an increase in its marks to febrile values.
- Massive bleeding, accompanied by oxygen starvation of brain tissue (hypoxia) and shortness of breath.
- Severe vomiting, the presence of a fistula in the stomach.
- Disorders in the work of the kidneys, accompanied by abundant flow of urine.
- Long-term and uncontrolled intake of drugs with a diuretic effect.
- Dehydration of the body.
- Severe infectious diseases.
- Taking glucocorticosteroids.
- Eating foods that contain a lot of alkalis, but a minimal amount of potassium.
- Treating acidosis with baking soda.
- Mass destruction of red blood cells with the release of hemoglobin.
- Massive surgery.
- Traumatic brain injury.
Alkalosis, depending on the cause that caused the violation, can be respiratory, mixed and non-gaseous. Regardless of what exactly caused alkalosis, this condition always negatively affects blood pressure, causing it to fall. The brain and heart suffer from malnutrition, and cardiac output decreases.
When the intercellular space of the body is alkalized, muscle tone increases, seizures may occur, and tetany develops. The intestine stops contracting normally, which provokes stool retention.
Compensated alkalosis is said to be when the pH level does not change, as it is regulated by the body's internal reserves. In this case, violations do occur. Uncompensated alkalosis is when the pH exceeds 7.45. In this case, the body is no longer able to cope with an excessive amount of alkalis, so their content in the blood begins to increase.
Respiratory (gas or respiratory) alkalosis develops against the background of respiratory disorders, while excessive amounts of carbon dioxide are excreted through the respiratory organs.
The following disorders can lead to hyperventilation of the lungs:
- Diseases of the central nervous system.
- Diseases of an infectious nature.
- Significant blood loss.
- Acute respiratory failure.
Hysteria, which is accompanied by severe shortness of breath. At the same time, there are no violations in the work of the cardiovascular and respiratory systems.
- Intensive therapy or connecting the patient to a ventilator.
- Intoxication of the body when salicylates enter it.
Gas alkalosis negatively affects cognitive processes. A person's memory and attention deteriorate, he begins to be disturbed by attacks of dizziness, loss of consciousness is possible.
There is also a non-gas alkalosis, which develops against the background of excessive excretion of hydrogen ions from the body, with sodium retention, with the release of acid from the stomach. Excretory alkalosis can manifest against the background of severe vomiting, when taking diuretics, with impaired renal function, with pathologies of the endocrine system. In this case, alkalization of the internal environment of the body occurs.
Another reason for exogenous non-gas alkalosis is an excess of soda solution in the body, it gets there when undergoing therapy for acidosis. Alkalization of the internal environment of the body can be observed when eating foods that contain a lot of alkali in their composition.
Metabolic alkalosis develops against the background of electrolyte metabolism disorders, when red blood cells begin to break down in the body. This can happen for a number of reasons, for example, after complex and massive operations, or with the development of rickets in children. Other causes of metabolic alkalosis: blood transfusion, vomiting, ingestion of gastric contents into the tracheobronchial tree, liver cirrhosis.
The acute course of alkalosis is most often caused by the infusion of a large amount of alkaline solutions into the body. Metabolic alkalosis causes the retention of alkalis inside the body. At the same time, the level of CO2 in the blood will remain within the normal range, and the amount of bicarbonates will increase.
In the chronic course of metabolic alkalosis, not only the buffer systems of the blood will be involved, but also the respiratory mechanism, which is responsible for the retention of carbon dioxide in the body. Most often, chronic metabolic alkalosis develops against a background of diseases of the digestive system, or after undergoing large-scale surgical interventions.
In chronic diseases of the digestive system, as well as with frequent blood infusions, not only the buffer systems of the blood, but also the kidneys, direct their efforts to eliminate alkalosis. Such a well-coordinated work of the body allows you to fully compensate for existing disorders and bring blood pH back to normal. However, there is always a danger that the body will one day simply fail, since its internal reserves are not unlimited.
Mixed alkalosis is said to be when acid and hydrogen are lost for several reasons at once, including vomiting, hyperventilation, hypoxia against the background of TBI.
Hypoxia of tissues with the removal of carbon dioxide from them increases, which causes the symptoms of alkalosis. This is expressed in a decrease in venous tone, a decrease in cardiac output, in excessive excretion of water and electrolytes in the urine, in a drop in blood pressure.
A person who develops alkalosis should first pay attention to the following symptoms:
- Frequent dizziness.
- Feeling of crawling on the skin, worsening of its sensitivity.
- Increased fatigue, excessive weakness.
- Feeling of lack of air.
- Increased heart rate and heart rate.
- Deterioration of cognitive abilities.
Excessive psychomotor agitation, pale skin or blue skin, increased anxiety - all this may indicate alkalosis. The patient will breathe frequently (up to 60 breaths per minute) if they develop respiratory alkalosis.
As the body begins to suffer from oxygen starvation, the heart will beat frequently, with a disruption to the normal rhythm. Blood pressure decreases. If a person is in a horizontal position, then any attempt to stand up can lead to the fact that it will fall even more. As a result, the person may even lose consciousness.
Disturbances in the work of blood vessels and electrolyte imbalance provoke more frequent urination in the patient. This, in turn, increases the likelihood of developing dehydration, which may lead to seizures. If the patient has another brain damage, for example, an aneurysm or tumor, then with jumps in the acid-base balance, the likelihood of an epileptic seizure increases.
The symptoms of metabolic acidosis are most often transient, moreover, they are compensated by the body's reserves. At peak increases in the alkaline component in the blood, respiratory depression and the formation of edema are possible.
With decompensated metabolic acidosis, symptoms such as diarrhea, vomiting, weakness, increased fatigue, thirst, loss of appetite are observed. In this case, the patient complains of headaches, periodic twitching of the muscles of the face and limbs.
The more calcium is excreted from the body, the stronger the convulsions. The skin that has lost moisture begins to peel off and crack, and folds appear on it. Infusion therapy provokes the occurrence of edema. Unlike respiratory alkalosis, the metabolic form of the pathological condition is accompanied by a decrease in respiration, but the pulse becomes more frequent. A person becomes apathetic to the world around him, his sleepiness increases, and a coma may develop.
People with stomach ulcers or acidic gastritis often try to relieve pain by drinking milk or alkaline drinks. This leads to the fact that they develop Burnett's syndrome. Alkalosis becomes chronic, which is expressed in increased weakness, lack of appetite. The patient is often nauseous, and sometimes vomits, the skin itches. In the renal tubules, calcium salts begin to be deposited, which leads to the development of renal failure.
Respiratory alkalosis leads to a deterioration in tissue nutrition, since an insufficient amount of blood is supplied to them. The pulse becomes more frequent, the muscle tone increases. Mental abnormalities develop when the pH level rises to 7.54. If the cause of the development of respiratory alkalosis is hysteria, then the patient shows pronounced anxiety, he is very irritated, aggressive.
Alkalosis in a child
Alkalosis is a condition that can affect not only adults but also children. Moreover, it is children who are susceptible to this condition to a greater extent, since the functioning of the buffer systems of their blood is imperfect.
Any disease that is accompanied by vomiting can cause alkalosis in childhood: intestinal obstruction, congenital stenosis of the stomach, trauma received during childbirth, infection with an infectious flora. Errors in the conduct of therapy using alkaline solutions or diuretics can also lead to alkalosis.
Metabolic disorders may be due to the factor of heredity. Metabolic alkalosis in a child against the background of Barter's syndrome develops during the first year of life. This is expressed in severe vomiting, an increase in body temperature, and a delay in physical development. The child urinates a lot and drinks a lot.
Respiratory alkalosis develops against the background of hyperventilation of the lungs. This condition can be provoked by ARVI, pneumonia, skull injuries, meningitis, encephalitis, brain tumors, and disturbances in the central nervous system. In this case, the symptoms of the underlying disease will come to the fore.
If calcium is excreted from the body of a young child, then cramps and muscle spasms will become a manifestation of this disorder. There is also tremor of the limbs, increased sweating. Older children complain of tinnitus, dizziness, and deterioration in sensitivity. If alkalosis has an acute course, then excessive excitement of the child and the development of coma are possible.
Diagnosis and treatment of alkalosis
If the doctor suspects alkalosis, then, in addition to the standard examination, he listens to the patient's lungs, his heart rate.
The next step is to undergo instrumental and laboratory diagnostics:
- ECG. With alkalosis, low-voltage teeth appear on the cardiogram.
- A biochemical blood test allows you to establish a low level of calcium, chlorine and potassium in the blood.
- Urinalysis shows an alkaline reaction.
Alkalosis therapy involves the elimination of the cause that led to the development of the pathological condition. In parallel, treatment is prescribed to normalize the blood balance. To do this, use gas mixtures that the patient must inhale, infusion therapy is performed. In this case, the patient is injected with solutions containing insulin, trace elements, ammonium chloride, drugs.
If a person is diagnosed with a mild form of alkalosis, which develops against a background of stress or neurosis, then treatment can be carried out at home. In addition to taking medications, the patient is prescribed a diet. It is important to exclude milk and dairy products from the menu. Be sure to eat boiled vegetables, steamed, fruits, cereals, low-fat meats.
To eliminate respiratory alkalosis, it is sometimes sufficient to reduce the respiratory rate. If a person has a panic attack or is very nervous, you need to try to calm him down, slow down his breathing. You can take a paper bag and breathe into it. This will increase the level of carbon dioxide in the blood, which will make it possible to bring your health back to normal.
Metabolic alkalosis and severe respiratory alkalosis require hospitalization. To stop seizures, calcium chloride is injected intravenously. Relanium is prescribed to reduce pulmonary hyperventilation. Morphine is administered for pulmonary edema to suppress respiratory function.
To eliminate electrolyte metabolism disorders, infusion therapy is performed using the following drugs:
- Intravenous administration of sodium chloride and calcium chloride.
- Intravenous administration of Panangin, potassium chloride and K-polarizing mixture.
- Reception of Veroshpiron.
To eliminate the causes that led to the development of alkalosis, the following drugs can be prescribed:
- Eliminate nausea and vomiting by taking the drug Metoclopramide.
- To remove severe intoxication, you can use hemodialysis.
- To eliminate diarrhea, drugs such as Motilium, Activated carbon, Loperamide can be used.
- For the treatment of nervous disorders, sedatives and antipsychotics are used, for example, Diazepam and Aminazin.
Sometimes surgery may be prescribed to treat alkalosis. For example, with stenosis or chronic stomach ulcer. In childhood, alkalosis therapy should be started after the pH level rises to 7.5. It is imperative to restore the body's water and electrolyte balance as soon as possible, it is possible to carry out infusion therapy, take vitamin C, amino acids.
Alkalosis responds well to treatment. The prognosis is the most favorable, provided that the pathology has a compensated course. A severe form of alkalosis requires the hospitalization of the patient and the appointment of intensive therapy. During treatment, monitoring of the biochemical composition of the blood is required.
The author of the article: Shutov Maxim Evgenievich | Hematologist
Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.