Vomiting Emesis

  • Facts:
    Repeated vomiting leads to a hypokalemic, hypochloremic metabolic acidosis

    1.) Vomiting leads to loss of gastric fluids (HCl, NaCl, H2O). The loss of H+ leads to the unbalanced retention of HCO3- . No gastric acid production by stomach, means no pancreatic HCO3- release, so HCO3- remains in blood, leading to metabolic alkalosis (generation)

    2.) As a result of fluid loss in vomitus, ECV contracts, leading to decreased renal perfusion. Kidneys activate renin-angiotensin- aldosterone system, and aldosterone serves to increase water reabsorption at the expense of H+ and K+ loss in urine (maintenance)
  • Treatment:
    IV normal saline and potassium

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July 23rd 2010