Categories: Nephrology

Post-hypercapnic Alkalosis: Mechanism

Post hypercapnic alkalosis (PHA) is frequently overlooked as a complication of acutely intubated & mechanically ventilated patients with COPD exacerbations.

HOW DOES IT WORK?

Post hypercapnic alkalosis refers to patients who are hypercapnic (chronic CO2 retainers) and develop a compensatory metabolic alkalosis due to renal bicarbonate (HCO3) retention. After they are intubated, their Pco2 is corrected rapidly, however their chronically elevated bicarbonate remains. This generates a metabolic alkalosis that is typically slow to fall.

REFERENCES

  1. B F Palmer and R J Alpern. Metabolic alkalosis. JASN. September 1, 1997 vol. 8 no. 9 1462-1469
  2. Banga A., Khilnani GC. Post-hypercapnic alkalosis is associated with ventilator dependence and increased ICU stay. COPD. 2009 Dec;6(6):437-40.
Get Medical Pearls directly to your inbox every week!
Weekly posts with high yield medical knowledge, directly to your mailbox!
Dr. C Humphreys

Internal Medicine

Recent Posts

What is Peribronchovascular Distribution on CT imaging?

A common finding described on computed tomography (CT) imaging. A disease with a peribronchovascular distribution…

2 months ago

Trapped Lung vs. Lung Entrapment

Though often used synonymously; Trapped Lung and Lung Entrapment technically describe separate entities along the…

8 months ago

Cause of Pericardial Effusion in Pulmonary Hypertension: Pathogenesis

It is not clearly understood why patients with pulmonary hypertension (PH) develop pericardial effusions. However,…

9 months ago

Difference between Mycophenolate Mofetil vs. Mycophenolate Sodium

The two drugs are not interchangeable nor dose equivalents. Mycophenolate mofetil (Cellcept) is a semi…

10 months ago

What is an “Anephric” Creatinine Rise?

Serum Creatinine can be a deceptive surrogate during an acute kidney injury. It may lag…

2 years ago

Macrophage activation syndrome vs. Hemophagocytic lymphohistiocytosis

Macrophage activation syndrome (MAS) is a life-threatening complication of rheumatic diseases (i.e SLE, Juvenile idiopathic…

2 years ago

This website uses cookies.