[Disorders of the acid-base equilibrium in delirium tremens].

The objective of the present work was to assess the most frequent disorder of the acid-base equilibrium in delirium tremens. The author examined a group of 77 alcoholics with delirium tremens. In 62 (80.5%) by the Astrup method respiratory alkalosis was detected, in 7 (9%) metabolic alkalosis was recorded, in 1 (1.5%) metabolic acidosis and in 7 patients (9%) the values of the acid-base equilibrium were normal. In predominant alkalotic syndrome the mean serum potassium level was lower, 3.4 mmol/l (2.2-4.6), and the level of chlorides 97.8 mmol/l (50-144.5). The mean sodium concentration was 138.1 mmol/l (121.5 to 147). The author discusses the causes of the impaired acid-base balance in delirium tremens. It is assumed that the main cause is the rebound phenomenon of the respiratory centre which causes hyperventilation and changes of the ion metabolisms induced by alcohol abuse and its discontinuation. A negative effect is exerted by shortage of energy substrates and protein catabolism the effect of ethyl alcohol on the intermediary metabolism, the psychosis as such, insufficiency of parenchymatous organs and neurohumoral dysregulation after discontinued alcohol intake. Examination of the acid-base equilibrium in delirium tremens is essential for differential diagnosis, correct treatment and prevention of complications. The author discusses briefly treatment of delirium tremens and principles of correction of associated acid-base and ion disorders.