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Hyperchloremia

Increased Chloride Levels


Presentation

  • Metabolic acidosis was common at presentation (mean base excess, -9.7 mmol/L) and persisted for 48 hrs.[ncbi.nlm.nih.gov]
  • Since the test was conducted days later we may expect a chronic respiratory alkalosis to be present, perhaps because of pain or a secondary pulmonary problem, as may be expected with a relatively low PaO 2 .[dovepress.com]
High Fever
  • Causes of hyperchloremia may include: Loss of body fluids from prolonged vomiting, diarrhea, sweating or high fever (dehydration). High levels of blood sodium.[inspire.com]
  • Causes of Hyperchloremia: Causes of hyperchloremia may include: Loss of body fluids from prolonged vomiting, diarrhea, sweating or high fever (dehydration). High levels of blood sodium.[chemocare.com]
  • A high fever that causes sweating and dehydration. Dehydration due to medications, intense exercise, heat exposure, or not drinking enough fluids. High sodium levels in the blood. Chloride tends to rise when sodium does. Too much salt intake.[medicalnewstoday.com]
Hypothermia
  • In fact, acidosis and hypothermia are two components of the triad of death (the third is coagulopathy). During a trauma, we spend much of our time correcting hypothermia, hypovolemia, and coagulopathy, while the acidosis gets scant attention.[trauma01.wordpress.com]
  • Table 1 Baseline characteristics of major trauma patients Hypotension and hypothermia were detected in 22 (71 %) and 10 (32 %) non-survivors, respectively. Both these proportions were significantly greater compared to those of survivors (Table 2 ).[link.springer.com]
Kussmaul Respiration
  • respirations) Weakness Tachypnea Hypertension Diagnostic Test Results-Laboratory Serum chloride level is greater than 108 mEq/L.[quizlet.com]
Constipation
  • Severe constipation, unrelieved by laxatives, lasting 2 to 3 days. Muscle twitching, irritability, increased urination, poor appetite that does not improve. If you notice excessive sleepiness, confusion.[chemocare.com]
  • Extreme nausea that interferes with eating and not relieved by medicines Vomiting more than 4 to 5 times in a day Diarrhea – 4 to 6 episodes in a day, and not relieved by diet modification or anti-diarrhea drugs Severe constipation for 2 to 3 days, and[healthooze.com]
Heart Disease
  • SH Board Certified Physician Doctoral Degree 6,399 satisfied customers I have hypertensive heart disease. BP 140/90. My serum I have hypertensive heart disease. BP 140/90. My serum amylase is 137 (Normal 30-110), Na 168 (Normal 137-145).[justanswer.com]
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. Keep yourself well hydrated if you have hyperchloremia.[chemocare.com]
  • disease, % 6.1 5.6 0.65 CHF, % 4.1 8.5 0.10 DM, % 21.4 21.1 0.71 COPD, % 21.4 18.3 0.086 Cirrhosis, % 7.1 4.9 0.082 Malignancy, % 4.1 5.6 0.20 HIV, % 11.2 9.2 0.56 Chronic steroid treatment, % 5.1 6.3 0.91 Clinical parameters at presentation MAP, mean[doi.org]
Muscle Twitch
  • Muscle twitching, irritability, increased urination, poor appetite that does not improve. If you notice excessive sleepiness, confusion.[chemocare.com]
  • twitching Poor appetite and increased urination Excessive drowsiness or confusion Hyperchloremia Prevention Dietary supplementation of magnesium in their food; but, should be taken under the doctor’s supervision only.[healthooze.com]

Workup

Chloride Increased
  • […] links to external sites (from Bing) Ontology: Hyperchloremia (C0085679) Concepts Disease or Syndrome ( T047 ) ICD10 E87.8 SnomedCT 74450001 English HYPERCHLORAEMIA, HYPERCHLOREMIA, Increased chloride levels, hyperchloremia, hyperchloremia (diagnosis), chloride[fpnotebook.com]
Hypercholesterolemia
  • Abstract Cholestyramine is recommended in the management of intractable diarrhea, cholestatic liver disease, and hypercholesterolemia.[nature.com]

Treatment

  • With careful management of fluids and food, and with prompt treatment for any underlying conditions, most people can regain normal electrolyte levels.[medicalnewstoday.com]
  • These results suggest that chloride values should be monitored closely during hypertonic saline treatment as moderate elevations may impact outcomes in intracerebral hemorrhage patients.[ncbi.nlm.nih.gov]
  • Treatment As with most types of electrolyte imbalance, the treatment of high blood chloride levels is based on correcting the underlying cause. If the patient is dehydrated, therapy consists of establishing and maintaining adequate hydration.[research.omicsgroup.org]
  • Such treatment is usually successful except in cases of central nervous system injury severe enough to produce death."[jamanetwork.com]
  • If the condition is caused or exacerbated by medications or treatments, these may be altered or discontinued, if deemed prudent.[en.wikipedia.org]

Prognosis

  • Keywords: ACID-BASE BALANCE: acidosis; HYDROELECTROLYTIC BALANCE: hyperchloremia; PROGNOSIS.[scielo.br]

Etiology

  • OBJECTIVE: Metabolic acidosis is common in septic shock, yet few data exist on its etiological temporal profile during resuscitation; this is partly due to limitations in bedside monitoring tools (base excess, anion gap).[ncbi.nlm.nih.gov]
  • . - Etiology of metabolic acidosis during saline resuscitation in endotoxemia. Shock 1998; 9:364-368. [ Links ] 17.[scielo.br]
  • Because of its iatrogenic etiology the authors commented that it is reassuring that hyperchloremic acidosis is not associated with an increased mortality.[ccforum.biomedcentral.com]

Epidemiology

  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
  • Epidemiology Respiratory alkalosis is common. Two large studies of inpatients from the US evaluating arterial blood samples showed a respiratory alkalosis prevalence of 22.5% to 44.7%. [6] Hodgkin JE, Soeprono FF, Chan DM.[bestpractice.bmj.com]
Sex distribution
Age distribution

Pathophysiology

  • However, the pathophysiology changed dramatically from one of unmeasured anions at admission (mean unmeasured anion base excess, -9.2 mmol/L) to predominant hyperchloremia by 8-12 hrs (mean sodium-chloride base excess, -10.0 mmol/L).[ncbi.nlm.nih.gov]
  • Useful For Suggests clinical disorders or settings where the test may be helpful Evaluation of water, electrolyte, and acid-base status Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory[mayomedicallaboratories.com]
  • Hypovolemia is an underlying pathophysiologic cause of hypochloremia. That's why I think, as does the OP, that the instructor has made a boo-boo here and needs to be challenged on it. Chloride and sodium exist as buddies together in the body.[allnurses.com]
  • Pathophysiology Chloride is the major negative electrolyte(anion) in the extracellular fluid. Plasma interstitial fluid of chloride anion is 103 mmol/L. Its concentration in intracellular fluid (RBC) is 45 to 54 mmol/L.[labpedia.net]

Prevention

  • Prevention Hyperchloremia can be hard to prevent, particularly when it is caused by a medical condition such as Addison's disease.[medicalnewstoday.com]
  • Recognition of this entity may prevent unnecessary and potentially harmful prolonged resuscitation.[ncbi.nlm.nih.gov]
  • Prevention of Hyperchloremia Through some easy-to-follow methods, hyperchloremia can be prevented to a large extent: Normal foods that a person takes daily needs to be rich in magnesium and potassium.[epainassist.com]
  • . #2 I think it's because carbonic anhydrase inhibitors prevent HCO3 reabsorption, so more sodium is being excreted as NaHCO3 instead of NaCl. #3 every non-anion gap acidosis has hyperchloremia. it's inevitable, and unimportant #4 It causes a non-anion[forums.studentdoctor.net]
  • A more appropriate solution to this problem would be to prevent developing the hyperchloremic acidosis at the outset by avoiding NS in the field, the emergency room, and operating room. Instead give Plasma-Lyte.[trauma01.wordpress.com]

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