[Metabolic alkalosis despite hyperlactatemia and hypercapnia. Interpretation and therapy with help of the Stewart concept].
Acid-base disturbances are commonly found in critically ill patients and are often associated with fatal complications. The basis of a successful treatment is a thorough understanding of the causes of these disorders. The "classical methods" to explain acid-base disorders--pH, base excess and bicarbonate concentration--mostly do not provide a causal correlation to the underlying pathology. An unusual case of a combined respiratory-metabolic disorder with hyperlactatemia and hypercapnia is presented. An acidosis masked by hypochloremic and hypoalbuminemic alkalosis was identified with the help of Stewart's concept and finally permitted a successful therapy. The modern Stewart concept provides enhanced information, enabling an exact diagnosis and causal therapy even in complex cases.
Chappell
D
D
Klinik für Anästhesiologie, Universitätsklinikum der Ludwig-Maximilians Universität, Nussbaumstrasse 20, 80336 München.
Hofmann-Kiefer
K
K
Jacob
M
M
Conzen
P
P
Rehm
M
M
D000136:Acid-Base Equilibrium / Q000502:physiology; D000138:Acidosis / Q000097:blood / Q000175:diagnosis; D000368:Aged; D000471:Alkalosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D001784:Blood Gas Analysis; D002712:Chlorides / Q000097:blood; D003422:Critical Care; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006935:Hypercapnia / Q000097:blood*; D034141:Hypoalbuminemia / Q000097:blood; D007773:Lactates / Q000097:blood*; D008297:Male; D015233:Models, Statistical
D002712:Chlorides; D007773:Lactates