Post-traumatic alkalosis, although apparently well tolerated in an uncomplicated postoperative course, is a potentially hazardous disorder in the critically ill patient.
This is particularly true for the digitalized cardiac patient, or the patient with hypocalcemia or hypokalemia, said two surgeons at Peter Bent Brigham Hospital, Boston.
The hazards of alkalosis include tetany, increased excretion of potassium, and production of excess lactic acid. Another potential hazard is tissue hypoxia resulting from hypocapnic vasoconstriction and inhibition of oxygen-hemoglobin dissociation following the elevation in pH (the Bohr Effect).
Reporting on the incidence and pathophysiology of alkalosis in surgery, John H. Lyons Jr., MD, now at Dartmouth Medical School, and Francis D. Moore, MD, chairman of the Department of Surgery, commented:
"In our experience, alkalosis is observed more frequently than acidosis among patients who have not deteriorated to the point of severe renal, circulatory or pulmonary decompensation. It is also far more common than