Are the abnormalities in metabolic alkalosis restricted to the ECF compartment?
No. There are abnormalities in both the ECF and intracellular fluid (ICF) compartments in patients with metabolic alkalosis.
The primary stimulus for these changes largely arises secondary to deficits of compounds that contain Cl − . In a small number of patients, there will be a positive balance for NaHCO 3 , but in these patients, hypokalemia plays a central role.
To understand the pathophysiology, one must examine how electroneutrality and balance were achieved in the ECF and ICF compartments and in the urine, as highlighted in the following clinical example.
