A patient with foot ulcer and severe metabolic alkalosis

A patient with foot ulcer and severe metabolic alkalosis

We report a case of triple acid-base disorder with metabolic alkalosis as the primary disorder in a 65-year-old man due to ingestion and application to leg ulcers of baking soda (calcium bicarbonate). The blood pH was 7.65 with hypochloremia, hypokalemia, and prerenal azotemia. He was treated with i...

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Veröffentlicht in:The American journal of emergency medicine 2012, Vol.30 (1), p.260.e5-260.e8
Hauptverfasser: John, Ruby Samuel, MD, Simoes, Sonia, MD, Reddi, Alluru S., MD
Format: Artikel
Sprache:eng
Schlagworte:
Acids
Acute coronary syndromes
Aged
Alkalosis - chemically induced
Alkalosis - complications
Bicarbonates - adverse effects
Bicarbonates - therapeutic use
Blood
Carbon dioxide
Emergency
Emergency medical care
Emergency Service, Hospital
Foot Ulcer - complications
Foot Ulcer - drug therapy
Humans
Ingestion
Ischemia
Laboratories
Male
Mortality
Ulcers
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Zusammenfassung:We report a case of triple acid-base disorder with metabolic alkalosis as the primary disorder in a 65-year-old man due to ingestion and application to leg ulcers of baking soda (calcium bicarbonate). The blood pH was 7.65 with hypochloremia, hypokalemia, and prerenal azotemia. He was treated with isotonic saline with K replacement, and the patient improved without any adverse clinical consequences. We discuss the causes, mechanisms, and management of Cl-responsive (depletion) metabolic alkalosis.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2010.10.035