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Feeding GI contents to combat alkalosis

MICU   (3,159 Views | 14 Replies)
by NHGN NHGN Member

5,337 Profile Views; 81 Posts

Hi all!

I am commenting on a discussion r/t alkalosis for my graduate APRN class. I want to write about the practice of returning gastic contents to the stomach (originally removed via GT to LWS, etc), to help combat alkalosis, but I am not coming up with appropriate search terms/phrases when looking for literature to back this up.

Does anyone have some ideas? I'd also like to know more about this practice! I'm out of the SICU for school or else I'd be asking my peers.

Thanks!

Eliza

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MomRN0913 specializes in ICU.

1,131 Posts; 19,648 Profile Views

eeewww;) I know, not very professional

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81 Posts; 5,337 Profile Views

What isn't professional? How I formed my post?? Certainly you don't mean the practice...

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fiveofpeep has 2 years experience and specializes in critical care, PACU.

1,237 Posts; 17,960 Profile Views

Probably wrong post.

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Perpetual Student has 4+ years experience and specializes in PACU.

682 Posts; 9,378 Profile Views

What isn't professional? How I formed my post?? Certainly you don't mean the practice...

I think she meant that her "eeewww" was unprofessional.

I'm just glad that by GI contents you meant the what came out of the stomach and not what came out of the south end!

Sorry, I've got nothing of substance to contribute, no pun intended.

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RN-LOGIC specializes in CTICU.

66 Posts; 4,412 Profile Views

the first question you should ask yourself is what causes metabolic alkalosis. it's the loss of hydrogen from gastrointestinal or urine system. right? i don't know. i mean, you are ready to push gastric contents to treat alkalosis. you should know that removal of gastric content does not lead to metabolic alkalosis. you asked why? then again you should know. it seems that you found a primitive and barbaric way to treat it. for every 1 meq of hydrogen loss you generate 1 meq

bicarbonate, however, when this happens in the gi system its matched with pancreatic bicarbonate. in other words, you do not give contents back.

you pretty much treat the underlying reason to treat the alkalosis.

i'll tell you how to treat alkalosis.

correct true volume depletion, potassium depletion, and chloride depletion. your practice is a joke............

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MomRN0913 specializes in ICU.

1,131 Posts; 19,648 Profile Views

I think she meant that her "eeewww" was unprofessional.

I'm just glad that by GI contents you meant the what came out of the stomach and not what came out of the south end!

Sorry, I've got nothing of substance to contribute, no pun intended.

Yes, that is what I meant. The practice of returning what's in those containers back into the body does gross me out. And I know, not so professional. All the same, we all have our thing that grosses us out.

There are gastric replacement protocols, but without gastric contents......

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81 Posts; 5,337 Profile Views

Ok, I reread your first comment, Mom, and it made total sense!!

And RN-Logic -- I'm so glad you get your rocks off by being the master of an online forum! I too could spend my time trying to think of brilliantly snarky comments while hiding behind my computer screen. Alas, I have a life! So frankly -- quit being such a b****!! I did NOT ask about what/why alkalosis happens -- did you read the post before getting prematurely excited about being able to grace me with your amazing knowledge base?

It's not MY practice - its a occasional practice at Yale. Like I said, it is low tech and a little bizarre, especially for a large trauma department. THAT'S why I'm looking for publications on it. Had you given me suggestions for search terms like I had asked, maybe I could have come to the conclusion that is not the best practice. However, I'll just go by what you said, since you're obviously a god.

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fiveofpeep has 2 years experience and specializes in critical care, PACU.

1,237 Posts; 17,960 Profile Views

I tried searching "returning gastric contents" but didn't find much. wish I could be of more help.

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22 Posts; 1,362 Profile Views

"For ever 1meq of hydrogen loss you generate 1meq"

I thought matter is neither created, nor destroyed....seeeems like I remember something about that.

Give me details on this...I'm curious.

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psu_213 has 6 years experience as a BSN, RN and specializes in Emergency, Telemetry, Transplant.

3,869 Posts; 28,250 Profile Views

meant the what came out of the stomach and not what came out of the south end!

Well, this is the 'new' tx for C diff...a stool "transplant" (I forget the exact term they use).

Anyway, the tx. the OP decribes may be "low tech" but it sounds like it could be reasonable.

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psu_213 has 6 years experience as a BSN, RN and specializes in Emergency, Telemetry, Transplant.

3,869 Posts; 28,250 Profile Views

You should know that removal of gastric content does not lead to metabolic alkalosis. You asked why? Then again you should know.

Are you sure about this? In my schooling I was always taught that loss of gastric contents (vomiting/suctioning/etc) can lead to metabolic allkalosis. I pulled out my patho book from school and it point to loss of gatric contents as a cause of metabolic acidosis as it causes a loss of hydrogen ions. Seems pretty straight foward to me.

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