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Please advise on infusing hydrochloric acid.

Schena FP, Kettritz R, Luft FC - Clin Kidney J (2012)

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology , Campus Virchow Klinikum, and Experimental and Clinical Research Center, Charité Medical Faculty , Berlin , Germany.

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The consult request encompassed the title of this report and elicited a double-take response in both of us... We found the request a bit out of the ordinary and hastened to our intensive care unit... However, the chart indicated the physicians' order for two ampules (40 mmol/ampule) of hydrochloric acid to be infused in 500 mL Ringer's acetate solution through a central venous catheter... The preparation also contained sodium 60 mmol/L, potassium 45 mmol/L and chloride 52 mmol/L... We concluded that our patient had an appropriately compensated metabolic alkalosis, and so therefore recommended that the order for hydrochloric acid infusion be discontinued and made some alternative recommendations regarding her care... Acetate is a derivative of acetic acid... The term includes salts and esters, as well as the anion found in solution... Similar to administration of bicarbonate, acetate can induce metabolic alkalosis... Generally, metabolic alkalosis does not occur with bicarbonate excretion because the capabilities of excreting bicarbonate are substantial... However, in patients with pre-existing chloride or potassium depletion (both were present in our patient), alkali ingestion results in a sustained increase in bicarbonate levels... In our patient, the anuria also eliminated her ability to lose any bicarbonate in exchange for chloride, via her ileal conduit... An acid-base disturbance not uncommonly has more than one mechanism, as was the case in this patient... None declared.

No MeSH data available.


Acetate ion.
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SFS112F1: Acetate ion.

Mentions: Acetate is a derivative of acetic acid. The term includes salts and esters, as well as the anion found in solution. The acetate anion [CH3COO]− belongs to the carboxylate family. Acetate is the conjugate base of acetic acid (Figure 1) and is metabolized to CO2, H2O and HCO3− (CH3COO−+ 2O2 = CO2 + H2O + HCO3−) at a 1:1 ratio. Similar to administration of bicarbonate, acetate can induce metabolic alkalosis. Generally, metabolic alkalosis does not occur with bicarbonate excretion because the capabilities of excreting bicarbonate are substantial. However, in patients with pre-existing chloride or potassium depletion (both were present in our patient), alkali ingestion results in a sustained increase in bicarbonate levels. Finally, in patients with renal failure, administered alkali is retained independent of body chloride or potassium stores. In our patient, the anuria also eliminated her ability to lose any bicarbonate in exchange for chloride, via her ileal conduit.Fig. 1.


Please advise on infusing hydrochloric acid.

Schena FP, Kettritz R, Luft FC - Clin Kidney J (2012)

Acetate ion.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400548&req=5

SFS112F1: Acetate ion.
Mentions: Acetate is a derivative of acetic acid. The term includes salts and esters, as well as the anion found in solution. The acetate anion [CH3COO]− belongs to the carboxylate family. Acetate is the conjugate base of acetic acid (Figure 1) and is metabolized to CO2, H2O and HCO3− (CH3COO−+ 2O2 = CO2 + H2O + HCO3−) at a 1:1 ratio. Similar to administration of bicarbonate, acetate can induce metabolic alkalosis. Generally, metabolic alkalosis does not occur with bicarbonate excretion because the capabilities of excreting bicarbonate are substantial. However, in patients with pre-existing chloride or potassium depletion (both were present in our patient), alkali ingestion results in a sustained increase in bicarbonate levels. Finally, in patients with renal failure, administered alkali is retained independent of body chloride or potassium stores. In our patient, the anuria also eliminated her ability to lose any bicarbonate in exchange for chloride, via her ileal conduit.Fig. 1.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology , Campus Virchow Klinikum, and Experimental and Clinical Research Center, Charité Medical Faculty , Berlin , Germany.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The consult request encompassed the title of this report and elicited a double-take response in both of us... We found the request a bit out of the ordinary and hastened to our intensive care unit... However, the chart indicated the physicians' order for two ampules (40 mmol/ampule) of hydrochloric acid to be infused in 500 mL Ringer's acetate solution through a central venous catheter... The preparation also contained sodium 60 mmol/L, potassium 45 mmol/L and chloride 52 mmol/L... We concluded that our patient had an appropriately compensated metabolic alkalosis, and so therefore recommended that the order for hydrochloric acid infusion be discontinued and made some alternative recommendations regarding her care... Acetate is a derivative of acetic acid... The term includes salts and esters, as well as the anion found in solution... Similar to administration of bicarbonate, acetate can induce metabolic alkalosis... Generally, metabolic alkalosis does not occur with bicarbonate excretion because the capabilities of excreting bicarbonate are substantial... However, in patients with pre-existing chloride or potassium depletion (both were present in our patient), alkali ingestion results in a sustained increase in bicarbonate levels... In our patient, the anuria also eliminated her ability to lose any bicarbonate in exchange for chloride, via her ileal conduit... An acid-base disturbance not uncommonly has more than one mechanism, as was the case in this patient... None declared.

No MeSH data available.