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3. Hypokalemia, metabolic alkalosis is often associated with hypokalemia. The mechanism is due to ion transfer. Intracellular alkalosis extracellular H move to balance the decrease in extracellular H, while K moves the cell to maintain electrical neutrality. This process also occurs in renal tubular epithelial cells, when intracellular K is increased, renal row K will increase. It can cause hypokalemia. From all previously described situation, hypokalemia was one of the causes metabolic alkalosis, and metabolic alkalosis can cause hypokalemia, the two can reinforce each other, this point is to be noted.(D) the principle of prevention1. To prevent and treat the primary disease caused by metabolic alkalosis.2. To correct hypokalemia, hypertriglyceridemia or low chlorine, such as supplementary KCl, NaCl, CaCl2, NH4Cl and so on. NH4Cl alkalosis both of which can be added to correct Cl-, however, should not be used in patients with liver dysfunction due to liver metabolism NH4Cl subject.3. Carbonate can be used to correct alkalosis liver enzyme inhibitors such as acetazolamide to inhibit renal tubular epithelial cells in the synthesis of H2CO3, thereby reducing the discharge of H and HCO3-reabsorption. Dilute HCl can also be used to neutralize the excess fluid in the NaHCO3. About 1mEq acid can decrease plasma [HCO3-] 5mEq / L or so. Aldosterone antagonists can reduce the H, K excretion from the kidney, but also a certain effect.Second,


the respiratory alkalosisRespiratory alkalosis (Respiratory Alkalosis) is characterized by a plasma [H2CO3] primary reduction.1. Spirituality hyperventilation is a common cause of respiratory alkalosis, but generally not serious. In severe cases, can have dizziness, paresthesia, occasional convulsions. Attack patients is common in hysteria.2. Abnormal metabolic processes such as hyperthyroidism and fever, the ventilation can be increased significantly more than the amount of CO2 emitted. Can lead to respiratory alkalosis, but generally not serious. But all that ventilation is not simply dependent on the body fluids [H] and Pco2, but also the strength and aerobic and metabolic status. Hyperventilation at this time may be increased pulmonary blood flow caused by reflex responses.3. Hypoxic hypoxia hypoxic hypoxia hyperventilation during hypoxia is a compensatory, but too much can cause respiratory CO2 emission alkalosis. Common access to the plateau, the mountains or the high altitude of the person; thorax and lung diseases such as pneumonia, pulmonary embolism, pneumothorax, pulmonary congestion and other causes of thoracic and pulmonary vascular or pulmonary afferent reflex by stimulating the patients to increase ventilation; In addition, Some congenital heart disease, due to increased right to left shunt caused by hypotonic hypoxemia can also over-ventilation. These are the decline in the plasma H2CO3 respiratory alkalosis.4. Central nervous system disorders encephalitis, meningitis, brain tumors, cerebrovascular accidents and brain injury patients by stimulating the respiratory center in some of the excitement, there hyperventilation.5. Salicylic acid poisoning, it can directly stimulate the respiratory center excitability increased sensitivity to normal stimulation also increased. Hence the over-ventilation.6. Gram-negative bacilli Gram-negative bacteria sepsis patients into the trail and reproduction, blood pressure, body temperature changes can not yet apparent hyperventilation. Pco2 who are as low as 17mmHg. This change is very helpful in the diagnosis. The mechanism is unclear, because animal experiments failed to replicate this phenomenon.7. Artificial respiration over.8. Cirrhosis of the liver cirrhosis with ascites and elevated blood NH3 hyperventilation may occur. Department of NH3 may stimulate the role of the respiratory center caused. Of course, ascites, diaphragm elevation are also stimulating the role of respiration, but the non-cirrhotic patients with ascites but no response to hyperventilation.9. Metabolic acidosis is corrected such as the use NaHCO3 sudden correction of metabolic acidosis, extracellular fluid [HCO3-] concentration rapidly rose to normal, but the brains through the blood barrier is slow, about 12 to 24 hours, when the brain is still metabolic acidosis, hyperventilation persists it. This has resulted in low H2CO3 respiratory alkalosis.10. Pregnancy increased a moderate degree of ventilation, it is more than CO2 output, the current opinion of the stimulation of progesterone on the role of the respiratory center, a number of synthetic progesterone preparations have this effect. Reaction of vomiting of pregnancy, inadequate diet can ketoacidosis, pregnancy reaction after a period of respiratory alkalosis may occur, sometimes causing tetany.(B) regulate the body's compensatory1. Inside and outside cells and intracellular ion exchange buffer acute respiratory alkalosis is the ion-exchange intracellular H transfer from the intracellular fluid to extracellular fluid to supplement the reduction of H, and K and Na from the extracellular fluid is transferred to cells fluid. H + HCO3- H2CO3, added extracellular HCO3-making has increased, while HCO3-is reduced.Intracellular buffering is reduced when the plasma Pco2, H2CO3 down, HCO3-/H2CO3 ratio increases, H2CO3-the relative increase, which can be buffered inside the cell to enter the red blood cell as an example the reaction is as follows:
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