Imbalance Of Acid-and-base

 IMBALANCE OFACID AND BASE 

赵高峰 PH.D 郑州大学一附院胸外科

Types of imbalance  

Acidosis-----alkalosis Respiratory-----metabolic

Metabolic Acidosis 

CONCEPT: metabolic causes result in more acidic materials(absolutely or/and relatively)accumulating in the body.causing symptoms and signs.----ph<7.35--acidosis.

Common reasons 

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Septic liquid loss from the inferior gastrointestinal tract Oligurea More acid produced(cardiac arresst,shock,thrill,infection,fever,injury,diabetes, et al) Others(exertion,tumor,et al)

manifestation  

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Myasthynea Deep and quick breath(reddish face and checks,lips,ears et al) Blood pressure---unstable or decreased Pulse---rapid ,mild Arrhythmia(heart rate decreased ) Others:spiritual and sycholi

Metabolic alkalosis 

Metabolic reasons result in more basic materials in the body(absolutely or relatively)---causing symptoms and signs

Causes

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Septic liquid loss from upper gastrointestinal tract (vomit,decompression of GI,et al) Basic materials ---intake too much(5%NaHco3 et al) Hypopotassemia Cl decreased ----alkalosis

Manifestations  

Mild and slow breath Spiritual and sycholi symptoms and signs

Respiratory acidosis 

Respiratory reasons ---- chest and lung diseases (Chest wall traumas,lung edema,CB,stenosis of T or/and B,et al)resulting in more CO2 accumulating in the body -----symptoms and signs

Causes of R-Acidosis      

Deep anesthynia , cardiac arresst, Pneumotharox Lung edema Stenosis of T or/and B Wrong use of respirator(Res—rate,vital volume)

manefestations    

Masthymia Dyspnea----cyanosis BP unstable or decreased ,pulse---rapid and mild, others

Respiratory alkalosis 

Respiratory reasons---high fever,nervous,injury to the head/brain,et al----less CO2 left in the body----symptoms and signs.

Causes of Res--alkalosis     

Fever Cry Injury to the brain Be nervous Wrong use of respirator(Res—rate,Vital—volume)

manifestations  

Slow and mild breath Others---spiritual and sycholi -----benumbed extremeties,thrill of the fingers et al

Diagnostic Rules   

Case history Manifestations Lab tests-----PH HCO3 Pco2

Lab tests  

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PH 7.35---7.45 <<7.56>> Hco3 8----12mmol/l metabolic factor // basic material <<25mmol/l>> Paco2 35---45mmol/l-----Respiratory factors acidic material <<25mmol/l>> Independent and interrelated

Treatments    

Acidosis-----basic medicine 5%NaHco3 Alkalosis----acidic medicine Hcl Metabolic imbalance----severe----medicine Respiratory imbalance-----no medicine used commonly(change the Res types---CO2----)

SUMMARRY   

Water Electrolyte Acid---base

WATER  

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Physiological volume----2000—2500ml Additional loss of water-------supply this as the same as the loss //Today Lost water-----before today // the lost total water volume-----mild 2% moderate 4% severe 6% of the weight------1/2—1/3 of the total should be given to the patient.

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You are dismissed All is over See you next year

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You are NO .1

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