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Metabolic Alkalosis

Metabolic alkalosis may be most conveniently subdivided into chloride resistant and chloride sensitive types. Chloride sensitive metabolic alkalosis occurs when Cl \ensuremath{^-} is lost in excess of Na \ensuremath{^+}. Chloride resistant metabolic alkalosis occurs when there is direct stimulation of renal HCO \ensuremath {_3^-} reabsorbtion.

Table 12: Different types of Metabolic alkalosis
  Cause Urinary Cl \ensuremath{^-}
Chloride Sensitive Cl \ensuremath{^-} lost in excess of Na \ensuremath{^+} \ensuremath{\downarrow} \ensuremath{< 10--20\ mmol}
Chloride Resistant Excess renal HCO \ensuremath {_3^-} loss \ensuremath{\uparrow} \ensuremath{> 10--20\ mmol}

The most common type seen in surgical practice is chloride sensitive, due to loss of upper gastro-intestinal secretions.


Adrian P. Ireland