Key messages

• Prevent metabolic alkalosis: restrict alkali and diuretic therapy.

• Treat underlying disease and suppress generating factors.

• Identify and reverse all maintaining factors.

• If there are clinical complications or alkalosis is severe, give intravenous HCl. Introduction

Metabolic alkalosis can result in serious clinical respiratory, cardiovascular, and neurological complications. Severe alkalemia is associated with increased mortality rate in critically ill patients. Thus effective prevention or therapy of metabolic alkalosis is warranted. More detailed discussions are given by Harrington and Kassirer (1982.), S.§b§tiDi,aDd,Ky^tZm§D,í,1994), and Galla,. (1995).

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