Nasogastric suctioning, metabolic alkalosis

Metabolic alkalosis is initiated by increased pH and I ICC)3, which can result from loss of H+ via the GI tract (e.g., nasogastric suctioning, vomiting) or kidneys (e.g., diuretics, Cushing s syndrome), or from gain of bicarbonate (e.g., administration of bicarbonate, acetate, lactate, or citrate). 

Respiratory alkalosis and metabolic alkalosis Example Hepatic failure and diuretics Patients on ventilation given nasogastric suction... 

Loss of gastric acid from vomiting or nasogastric suction- ing is often responsible for the development of a metabolic alkalosis, characterized by hypochloremia and hyperbicar-bonatemia. 

The combination of respiratory and metabolic alkalosis is the most common mixed acid-base disorder. This mixed disorder occurs frequently in critically ill surgical patients with respiratory alkalosis caused by mechanical ventilation, hypoxia, sepsis, hypotension, neurologic damage, pain, or drugs, and with metabolic alkalosis caused by vomiting or nasogastric suctioning and massive blood transfusions. It may also occur in patients with hepatic cirrhosis who hyperventilate, receive diuretics, or vomit, as well as in patients with chronic respiratory acidosis and an elevated plasma bicarbonate concentration... 

A patient who has had prolonged nasogastric. suction following surgery will lo.se gastric lliiid in large quantities and may develop a metabolic alkalosis. 

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