{"id":25545,"date":"2020-11-06T13:56:23","date_gmt":"2020-11-06T12:56:23","guid":{"rendered":"https:\/\/blog.uchceu.es\/veterinaria\/?p=25545"},"modified":"2020-12-15T14:48:33","modified_gmt":"2020-12-15T13:48:33","slug":"alcalosis-metabolica","status":"publish","type":"post","link":"https:\/\/blog.uchceu.es\/veterinaria\/alcalosis-metabolica\/","title":{"rendered":"Alcalosis metab\u00f3lica. \u00a1La olvidada en Medicina Veterinaria!"},"content":{"rendered":"

El pasado mes de Octubre, Diana defendi\u00f3 su TFG sobre la alcalosis metab\u00f3lica<\/strong> en peque\u00f1os animales. Aqu\u00ed os dejo un resumen de su trabajo, que os har\u00e1 replantearos esta patolog\u00eda e instaurarla dentro de vuestros diagn\u00f3sticos diferenciales si trabaj\u00e1is en urgencias.<\/p>\n

\"Diana
Diana Uribelarrea, alumna de 5\u00ba curso de Veterinaria<\/figcaption><\/figure>\n

El equilibrio \u00e1cido-base es uno de los mecanismos homeost\u00e1ticos m\u00e1s importantes del organismo y su principal funci\u00f3n es el de mantener el pH dentro de unos l\u00edmites estrictos. <\/span><\/h3>\n

Para el organismo de los seres vivos resulta tan importante mantener este equilibrio, que existen sistemas compensatorios preparados para equilibrar la m\u00e1s m\u00ednima alteraci\u00f3n, ya sea v\u00eda sistema respiratorio (la v\u00eda r\u00e1pida) o v\u00eda sistema renal (la v\u00eda lenta). No obstante, cuando un paciente viene a la consulta inestable, estos sistemas no son suficientes y necesita ayuda externa.<\/span>\u00a0<\/span><\/p>\n

En el mundo de la medicina veterinaria, la alcalosis metab\u00f3lica ocupa el tercer puesto de los desequilibrios \u00e1cido-base\u00a0<\/strong><\/span>presentes\u00a0en los pacientes de nuestras\u00a0UCIs<\/strong>,<\/strong> siendo la m<\/span>\u00e1<\/span>s diagnosticada la acidosis\u00a0<\/span>metab\u00f3lica<\/span>.\u00a0<\/span>Esto es as\u00ed porque el cuerpo ya tiende de por si a una ligera acidosis fisiol\u00f3gica y las patolog\u00edas m\u00e1s comunes que llegan a una consulta de urgencia impiden\u00a0<\/span>esa regulaci\u00f3n cotidiana antes explicada<\/span>\u00a0(Ej. Disnea, fallo card\u00edaco, diarrea, enfermedad renal, cetoacidosis diab\u00e9tica, intoxicaciones,\u00a0<\/span>uroabdomen<\/span>\u2026). No obstante, los problemas nunca vienen solos y no es com\u00fan encontrarse con una sola alteraci\u00f3n \u00e1cido-base.<\/span> El diagn\u00f3stico y el pron\u00f3stico se complica cuando nos encontramos dos alteraciones principales o una alteraci\u00f3n principal y una respuesta compensatoria en proceso.<\/span><\/p>\n

\"Algoritmo
Algoritmo diagn\u00f3stico Alcalosis metab\u00f3lica. Elaborado por Diana Uribelarrea<\/figcaption><\/figure>\n

Pero<\/span>\u00a0si la alteraci\u00f3n\u00a0<\/span>m\u00e1s<\/span>\u00a0frecuente en veterinaria es la acidosis metab\u00f3lica<\/span>\u00a0\u00bf<\/span>Por qu\u00e9 hablamos de la alcalosis metab\u00f3lica<\/span>?<\/span>\u00a0<\/span><\/h3>\n

Porque su diagn\u00f3stico incorrecto provoca que el paciente no responda al tratamiento pautado, derivando en altas tasas de mortalidad. La alcalosis metab\u00f3lica\u00a0<\/span>se presenta con un aumento del\u00a0<\/strong><\/span>PH\u00a0y un aumento del HCO3-<\/strong>\u00a0<\/strong>normalmente asociado a una obstrucci\u00f3n intestinal proximal<\/span> y otras patolog\u00edas que provoquen la perdida de hidrogeniones<\/span>.<\/span><\/p>\n

\"Causas
Causas de la alcalosis metab\u00f3lica. Elaborado por Diana Uribelarrea<\/figcaption><\/figure>\n

Adem\u00e1s, suele ir acompa\u00f1ado de un aumento en la pCO<\/strong><\/span>2\u00a0compensatorio y la disminuci\u00f3n de electrolitos como el cloro, el sodio y el potasio<\/strong>\u00a0que cronifican el estado del paciente si no se resuelve durante la hospitalizaci\u00f3n<\/span>.<\/span>\u00a0<\/span><\/p>\n

\"Algortimo
Algortimo tratamiento alcalosis metab\u00f3lica. Elaborado por Diana Uribelarrea<\/figcaption><\/figure>\n

Tras una revisi\u00f3n bibliogr\u00e1fica de la alcalosis metab\u00f3lica, tanto en medicina humana como en medicina veterinaria,\u00a0<\/span>nos llama la atenci\u00f3n que en medicina humana la incidencia de la alcalosis metab\u00f3lica sea del 50%<\/strong>, coloc\u00e1ndose como la primera alteraci\u00f3n \u00e1cido-base en el ranking.\u00a0<\/span><\/p>\n

Su protocolo hospitalario presenta<\/span> una monitorizaci\u00f3n m<\/span>\u00e1s<\/span>\u00a0exhaustiva\u00a0<\/span>que<\/span>\u00a0la presente en la hospitalizaci\u00f3n veterinaria<\/span>\u00a0y sus tasas de mortalidad son menores. Tambi\u00e9n existe una marcada diferencia en los protocolos hospitalarios veterinarios de diferentes pa\u00edses, siendo la monitorizaci\u00f3n m\u00e1s intensiva en pa\u00edses con presencia de hospitales veterinarios grandes y veterinarios formados en la especialidad de urgencias. <\/span><\/p>\n

Todo ello nos hace pensar que la especializaci\u00f3n del veterinario en urgencias y el acceso a las gasometr\u00edas son variables a tener en cuenta en la incidencia real de la alcalosis metab\u00f3lica.<\/span>\u00a0<\/span><\/p><\/blockquote>\n

\u00a0Gracias Diana por compartir toda esta informaci\u00f3n con nosotros!!<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

El pasado mes de Octubre, Diana defendi\u00f3 su TFG sobre la alcalosis metab\u00f3lica en peque\u00f1os animales. Aqu\u00ed os dejo un resumen de su trabajo, que os har\u00e1 replantearos esta patolog\u00eda e instaurarla dentro de vuestros diagn\u00f3sticos diferenciales si trabaj\u00e1is en urgencias. El equilibrio \u00e1cido-base es uno de los mecanismos homeost\u00e1ticos m\u00e1s importantes del organismo y […]<\/p>\n","protected":false},"author":92,"featured_media":25565,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[320],"tags":[1104,1106,1105],"class_list":{"0":"post-25545","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-nuestros-alumnos","8":"tag-alcalosis-metabolica","9":"tag-alteraciones-equilibrio-ac-base","10":"tag-tfg-ceu-uch"},"yoast_head":"\nAlcalosis metab\u00f3lica. \u00a1La olvidada en Medicina Veterinaria!<\/title>\n<meta name=\"description\" content=\"Quieres saber m\u00e1s sobre esta patolog\u00eda infradiagn\u00f3sticada en medicina veterinaria? 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