Postoperative metabolic alkalosis and acute renal failure: rationale for the use of hydrochloric acid.

Abstract:

:Metabolic alkalosis secondary to chloride depletion, especially following gastrointestinal surgery and associated with acute renal failure, is a frequent clinical occurrence. Management of the resultant acid-base disturbance mandates chloride replacement. The presence of oliguria limits the choice of accompanying cation. The use of intravenous hydrochloric acid to correct and maintain proper chloride balance, secondary to external gastric fluid losses, is recommended as a straightforward approach. Two brief case synopses are presented. Both patients, florid examples of profound chloride depletion, required large amounts of intravenous hydrochloric acid. The options regarding the choice of chloride solution, hazards involved, and a simplified schema of replacement therapy are presented. Combined gastrointestinal and renal dysfunction create unusual biochemical and clinical alterations and may result in a complex management problem.

journal_name

Surgery

journal_title

Surgery

authors

Shavelle HS,Parke R

subject

Has Abstract

pub_date

1975-10-01 00:00:00

pages

439-45

issue

4

eissn

0039-6060

issn

1532-7361

pii

0039-6060(75)90236-6

journal_volume

78

pub_type

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