Severe Alkalemia (pH 7.85): Compatible with Life? A Triple Acid-Base Conundrum

¹Department of Emergency medicine/ Internal Medicine resident at Rowan-SOM in Stratford, NJ, USA.

²Assistant professor, Department of Emergency at Rowan-SOM and an attending physician at Kennedy USA.

³Associate program director of emergency medicine residency at Rowan School of Osteopathic Medicine and an attending physician at Kennedy USA.

⁴Pulmonary Critical Care, Kennedy University Hospital, Washington Twp, NJ, USA.

⁵Pulmonary Critical Care, Rowan-SOM, Stratford, NJ, USA.

Corresponding Author: Kishan B Patel, Department of Emergency medicine/ Internal Medicine resident at Rowan-SOM in Stratford, NJ, USA, Tel: 765-448-8000; E-Mail:[email protected]

Received Date: 12 Feb 2016   
Accepted Date: 10 Jun 2016   
Published Date: 13 Jun 2016

Copyright © 2016 Patel KB

Citation: Patel KB, Espinosa J, Wiley J, Roy N, et al. (2016). Severe Alkalemia (pH 7.85): Compatible with Life? A Triple Acid-Base Conundrum. Mathews J Case Rep 1(2): 010.

ABSTRACT

Acid- Base disorders are a common occurrence seen in emergency medicine. An infrequent occurrence is one with a triple acid base disorder in which one of the derangement predominates to generate an alkalemia with a pH of > 7.60. Severe alkalemia with a pH > 7.65 is associated with a high mortality rate. Early recognition and aggressive management of the underlying acid base disorders is imperative for survival. Here we describe a case in which a patient presented with a gapped metabolic acidosis, presumed secondary to diabetic ketoacidosis, as well as a concurrent severe metabolic alkalosis with a pH of 7.85 and a respiratory alkalosis, which was secondary to a paradoxical unexpected respiratory response.