Korkmaz A, Yildirim E, Aras N, Ercan F
Sixth Department of Surgery, Numune Hospital, Ankara, Turkey.
Jpn J Surg. 1989 Sep;19(5):519-23. doi: 10.1007/BF02471657.
Six patients with severe metabolic alkalosis were treated with intravenous hydrochloric acid (HCl) infusion. HCl was given through a central venous catheter, at a concentration of 0.1 mEq per ml. At least two of the following criteria were considered for initiation of the therapy: An arterial pH of greater than 7.45, a base excess (BE) of greater than +7 mmol/L, a PaCO2 of greater than 50 mmHg. The HCl amount was calculated using the BE formula, however, two thirds was infused for avoiding excessive acid loading. Patients were monitored by the blood gases, serum electrolytes, hemoglobin, hematocrit, bilirubin determinations and blood smear findings. While a significant decrease was noticed in pH and BE values, moderate changes were detected in PaCO2 due to different ventilatory status of the cases. All laboratory test results remained within normal limits and no complication was encountered. The advantage of the therapy is that less volume is needed for the correction of alkalosis, particularly in the cases requiring fluid restriction. HCl therapy, moreover, is a safe and time-saving method because of having rapid response to the treatment in the critically ill surgical patients.
6例严重代谢性碱中毒患者接受了静脉输注盐酸（HCl）治疗。HCl通过中心静脉导管给药，浓度为每毫升0.1毫当量。开始治疗时至少考虑以下标准中的两条：动脉pH大于7.45、碱剩余（BE）大于+7 mmol/L、动脉血二氧化碳分压（PaCO2）大于50 mmHg。HCl用量使用BE公式计算，然而，为避免酸负荷过重，只输注计算量的三分之二。通过血气、血清电解质、血红蛋白、血细胞比容、胆红素测定和血涂片检查对患者进行监测。虽然pH值和BE值显著下降，但由于病例的通气状态不同，PaCO2有中度变化。所有实验室检查结果均保持在正常范围内，未出现并发症。该治疗方法的优点是纠正碱中毒所需的液体量较少，特别是在需要限制液体摄入的病例中。此外，HCl治疗对重症外科患者治疗反应迅速，是一种安全且节省时间的方法。
