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Contraction alkalosis is an increase in blood pH caused by a change in overall fluid volume in the body. The patient can experience symptoms like fatigue and muscle weakness as the pH rises and the balance of electrolytes changes. This condition is typically treated with an infusion of fluid to restore the patient’s fluid volume and stabilize the electrolytes. Patients may need custom fluid boluses, depending on why they lost fluid originally.
Vomiting is a common cause of this condition. Patients who experience prolonged episodes of vomiting can lose a lot of fluid and disrupt their electrolytes because they are not getting enough nutrients. Diarrhea can cause similar problems, as can excess urination caused by diuretics. The patient may also develop hypokalemia, where the level of potassium in the blood drops too low. This can contribute to muscle pain and weakness during a case of contraction alkalosis.
Blood testing can demonstrate that a patient has contraction alkalosis or it may be suspected given the patient’s recent medical history. Patients who have lost a lot of fluid are often preemptively provided with fluids to prevent conditions like this. This keeps them hydrated, may reduce the chance of developing dangerously low blood pressure, and keeps electrolyte levels stable. If a patient arrives at a hospital for treatment and reports recent episodes of vomiting or heavy diuretic use, fluids may be recommended as a precaution.
With the administration of appropriately balanced fluids, the patient’s pH should start to stabilize. Patients will start to feel better. Muscle pain and soreness can be resolved with added potassium in the infusion. While the patient receives care for the contraction alkalosis, medical providers can explore the cause and determine if additional treatment is needed. For example, someone who is vomiting and can’t stop might need an antiemetic, along with treatments like antibiotics for a bacterial infection to prevent another episode of contraction alkalosis.
Several other medical issues can cause alkalosis. If there are concerns about why the patient’s blood pH rose, a workup may be recommended to learn more. Fluids may be given while waiting for results because they are often beneficial. Patients who start to feel better on fluids should wait for the infusion to finish and confirm that they are ready to be discharged before leaving. They could experience a relapse if they don’t wait for a full evaluation to determine and correct the underlying cause of the alkalosis.
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