The Generation and Maintenance of Metabolic Alkalosis in Intensive Care Unit

Abstract

Background: Metabolic alkalosis is a common acid-base disorder in critically ill patients and can contribute to adverse outcomes if not managed appropriately. Understanding its etiology and optimal treatment strategies in the intensive care unit (ICU) is crucial for improving patient care and reducing complications.

Objective: This study aimed to identify the underlying causes of metabolic alkalosis in ICU patients and evaluate the effectiveness of different management approaches in improving patient outcomes.

Materials and Methods: A prospective analysis was conducted in the Critical Care Medicine Department to assess metabolic alkalosis in ICU patients. Data were collected on patient demographics, clinical symptoms, and arterial blood gas (ABG) parameters, including pH, bicarbonate levels, and electrolyte concentrations. The study explored contributing factors such as diuretic use and persistent vomiting. Laboratory investigations, including ABG analysis, serum electrolytes, and renal function tests, were performed to establish correlations between these factors and the development of metabolic alkalosis.

Results: The study included 80 patients, with 61.25% being male and 38.75% female. The most common causes of metabolic alkalosis were diuretic therapy (48.75%) and hemodynamic instability (51.25%). Management primarily involved normal saline administration, with potassium chloride supplementation provided to 50% of hypokalemic patients. Adjustments to diuretic doses were made to prevent further organ dysfunction. ABG monitoring over three days revealed significant improvements in pH (p < 0.001) and bicarbonate levels (p < 0.001).

Conclusion: Effective management of metabolic alkalosis in ICU patients requires a structured approach, including the regulation of diuretic therapy and fluid resuscitation with normal saline. Addressing electrolyte imbalances, particularly hypokalemia and hypochloremia, is essential for patient stabilization and recovery. The successful transfer of 75% of patients to the general ward suggests that appropriate interventions can reduce ICU stays and associated healthcare costs. Implementing these strategies in clinical practice may enhance patient outcomes and optimize resource utilization in ICU settings.