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Previous Volume 338:107-111 January 8, 1998 Number 2 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Adverse Consequences of Severe Alkalemia

Severe alkalemia (blood pH greater than 7.60) can compromise cerebral and myocardial perfusion by causing arteriolar constriction, an effect that is more pronounced in respiratory than in metabolic alkalosis (Table 2).^69,70,71 Neurologic abnormalities may ensue, including headache, tetany, seizures, lethargy, delirium, and stupor. The associated reduction in the plasma concentration of ionized calcium probably contributes to these manifestations. Although it exerts a moderate positive inotropic effect on the isolated heart, alkalemia reduces the anginal threshold and predisposes the patient to refractory supraventricular and ventricular arrhythmias. This arrhythmogenic action is more pronounced in patients with underlying heart disease. Alkalemia . . . [Full Text of this Article]

Management of Life-Threatening Alkaloses

Metabolic Alkalosis

Respiratory Alkalosis

Pseudorespiratory Alkalosis

Mixed Alkaloses

Source Information

From the Department of Medicine, Baylor College of Medicine and Methodist Hospital, and the Renal Section, Veterans Affairs Medical Center, Houston (H.J.A.), and the Department of Medicine, Tufts University School of Medicine, and the Division of Nephrology and the Tupper Research Institute, New England Medical Center, Boston (N.E.M.).

Address reprint requests to Dr. Madias at the Division of Nephrology, New England Medical Center, Box 172, 750 Washington St., Boston, MA 02111.

References

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