Mennen M, Slovis C M
Division of Emergency Medicine, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia 30335.
Ann Emerg Med. 1988 Apr;17(4):354-7. doi: 10.1016/s0196-0644(88)80781-9.
A case of severe metabolic alkalosis (MA) resulting from ingestion of baking soda (sodium bicarbonate) is presented. On admission to the emergency department, the patient was alert and stable with an initial examination that was remarkable only for carpopedal spasm. Shortly thereafter, the patient had a sudden, unexpected cardiopulmonary arrest. Following resuscitation, without administration of sodium bicarbonate, the arterial blood gas revealed a pH of 7.73, pO2 of 51 mm Hg, and pCO2 of 52 mm Hg. After admission to the intensive care unit, the patient's MA was corrected using IV 0.25 N hydrochloric acid. The patient remained comatose as a result of severe anoxic encephalopathy and died two weeks after admission. We believe this is the first reported case of severe MA resulting in sudden cardiopulmonary arrest in a previously ambulatory patient.
本文报告一例因摄入小苏打（碳酸氢钠）导致严重代谢性碱中毒（MA）的病例。患者急诊入院时意识清醒，情况稳定，初检仅发现手足搐搦较为明显。此后不久，患者突然意外发生心肺骤停。复苏后，未给予碳酸氢钠，动脉血气显示pH值为7.73，氧分压（pO2）为51 mmHg，二氧化碳分压（pCO2）为52 mmHg。入住重症监护病房后，使用0.25 N盐酸静脉输注纠正患者的代谢性碱中毒。患者因严重缺氧性脑病仍处于昏迷状态，入院两周后死亡。我们认为，这是首例报告的严重代谢性碱中毒导致既往可自由活动的患者突然发生心肺骤停的病例。
