Metabolic acidosis and therapy. Acidosis - also: symptoms and treatment Compensation for metabolic acidosis

The acid-water balance is regulated by the systems of the body, allowing the rest of the normal functioning. In case of diagnosed acidosis, the development of acid damage in the history of acidosis is associated with a head symptom. Reasons to allow visas to be paid for. Metabolic acidosis is observed.

There is also an increase in acidity in the body, so that acidosis develops. The reason is the lack of vitality to the body and oxidation. So much to take intestinal damage, Hunger and hot stun, to produce acetoacetic acid, acetone, and coma in important ways to the point of being approved in the section.

Site site vidіlya kіlka vidіv acidosis:

• Compensated type.
• Subcompensated type.
• Uncompensated type.
• Gas in case of impaired ventilation of the lungs and inhaled great amount of CO2.
• Non-gas - last for:

1. Metabolic - accumulation of acidic products in tissues, which are stored in organisms.
2. Vidіlnoї - vіdnіstnі vіdvіnnya nirkami nirkami of non-flying acids and the increase in the number of PCTs in the absence of submission.
3. Exogenous is a hopeful of a great number of elements, so that it can take a part in approved acids.
4. Zmіshaniy.

metabolic acidosis

The most common type of acidosis is metabolic. With this kind of vyroblyaєte a lot of acid, yak in even small quantities vivoditsya.

Metabolic acidosis lasts for:

• Diabetic ketoacidosis, when there is an excess of ketone cells in the body.
• Hyperchloremic acidosis forms when bicarbonate is injected, for example, when there is diarrhea.
• Lactic acidosis is the accumulation of lactic acid through the malignancy of alcohol, the great physical options, Malicious poohlin, hypoglycemia, implantation of medications, anemia, sudoma syndrome etc.

Metabolic acidosis manifests itself in the onset symptoms:

1. Stunned, soporous abo gagging camp.
2. The dikhannya is quickened.
3. Shock i, yak result, death.

The Danish type of ailment is diagnosed by way of blood analysis for acid-water balance. Lіkuvannya are recruited to the usunennya pershoprichini. Sodium bicarbonate is injected internally, or sodium bicarbonate is injected in the middle. The disease did not lead to a lethal result, to the point of producing metabolic acidosis, which would lead to a loss.

Lactic acidosis

Lactic acidosis є In one more widening of the disease, in which case the value of the accumulated lactic acid is meant. Type A is defined as an explicit tissue anoxia. Type B practically does not manifest itself.

Type A appears more often. Type B manifests itself in a daunting manner, the reason for which has not been reliably revealed yet.

Type A lactic acidosis develops through:

1. Diabetes.
2. Epilepsy.
3. Sudomnikh stanіv.
4. Hvorobi Hodzhkin.
5. Ailment of the stove and nirok.
6. Neoplasia.
7. Milomi.
8. Infections.
9. Leukemia.
10. Bacteriєmii.
11. Generalized lymphomi.

Type B lactic acidosis develops through the development of arthritis, toxins and lactic acidosis.

cause acidosis

Preserving the normal acid-puddle balance is an equally important factor as the visibility of any infectious ailments. The main reasons for the diagnosis of acidosis are the way of life, poor daily routine and improper eating. This is also the beginning of ecology, in yak lyudin perebuvaє.

The role of vіdіgraє kharchuvannya is even more important. It’s worthwhile to avoid acidosis. Acid in the body is the result of a drop and oxidation of elements in the food. Importantly, nirkas and legends were praised for all the good. Nirks add to the vivedenna non-flying elements, and the light ones - flying ones.

Besides, the organism is not to blame for the failure of the exchange of words, and it can also be caused by the day-to-day chronic illness, as it provokes a latent excess of acidosis. Before them, there are puffs, allergic reactions, neuroses, rheumatism, and too much tissue.

symptoms of acidosis

Acidosis often presents with these symptoms, which can flare up into a headache. V easy form it might not show up. Hourly wіn wіklikє nudotu, vomiting and stomachache. An important form is manifested in the destructions of the frequency і glibini dichannya, the heart's speed і stunned. It is also an important form to be considered as damaged in the exchange of words in the brain. Tse bring to the post-sleepiness and comi.

Gostra form of acidosis develops on the appearance of a carry and lack of blood supply to tissues. Decreases in blood provocation, shock, blood loss and heart defect.

In children, acidosis can manifest itself through congenital illness. Tse start on its development, to bring up to the court and galvanosti character.

Pochatkova stage can be recognized by:

• Weaknesses.
• Headache.
• Sleepiness.
• Mlyavosti.
• implications nervous system.

To improve acidosis, it will appear as follows:

at reddish diabetics the smell of fruit in the mouth, in addition to the signs, is recognized.

Acidosis and alkalosis

When the form of ailment is compensated, a change is made with sodium hydrocarbonate and carbonate acid. In the case of decompensation of the form, the deterioration of the amount of acids and meadows is indicated in the direction of the excess of one of the branches.

To often achieve acidosis due to nonrespiratory reasons. Tse of accumulation of lactic acid, acetoacetic aboxybutyric acid. The accumulation of lactic acid is often indicated through the deterioration in the robot's heart and leg (kisneve hunger). Likewise, the disease grows on aphids carried. In such a type of organism, organism includes compensatory functions, if the balance between acids and meadows is observed.

Alkalosis and acidosis are associated with robotic organisms. Dikhannya is changing, the tone of the Sudin is falling, and the heart is getting lower. arterial vise... Water and electrical balance will break down. Kistki take in their hardness, step by step they pick up the changes in the robot's heart.

lykuvannya acidosis

Oskilki acidosis practically does not manifest itself, then the liking is directed to the assertion of the reasons for its diagnosis. However, the very thing itself does not slurp without respect. Acidosis is elusive in case of mild forms of this manifestation. Zlikiv mean sodium bicarbonate in the middle in case of light form or internally in case of importance. Calcium carbonate is recognized, if it is necessary to enclose a bit of sodium in case of hypocalcism.

Metabolic acidosis is associated with:

1. Hydrocarbonate sodium.
2. Nicotinic acid.
3. Cocarboxylase.
4. Riboflavin mononucleotide.
5. Glutamic acid.
6. Dichloroacetate.

In case of pathologies of the slunk-intestinal tract, oral administration of Regidratation sil, Dimephosphon.

The head emphasis is to be afraid of the correct food. It takes an hour to drink and drink to drink and drink. Fruits, fats of roslinnogo pokazhennya, berries, fresh vegetables are taken at once with bіlim hlіb, pasta virobs, food fats. It is actively recommended to accept food from rice for the production of toxins, slags and other high-energy elements.

forecast

Acidosis is indicated on the functionality of the entire body. As the acid-water balance breaks down, so also the systems break down. In the main, the heart is suffering, the legends and nirki. However, acidosis often affects the development of other ailments, which is infused into the deterioration of the metabolic processes. The prognosis will be more likely to be found during the drug visits and the reason for the acidosis itself.

The triviality of life is due to the fact that there is a lot of acidosis. In the case of the deyakikh vipadkah mov ide about the lethal end, as the ailments do not live any calls.

Acidosis develops through the accumulation of products, which is established in case of overwhelming oxidized organic spolu, if the organism does not rise to it quickly. Tse wiklikєatsya yak internal reasons, So and zvnіshnіmi. internal officials talk about the pathologies of the functions of the developmental systems, Yaki produce up to metabolic damage and accumulation of metabolites, which is established when oxidized. calling reasons turn on, first for everything, inhaling crazy madness, in which there is a tendency to change in the place of carbon dioxide. An important accelerated acidosis is a shock abo Komov Stan. This is also a potentially lethal result.

Independently of the ethological factor, the acidotic stage is produced to serious acceleration. To them are admitted:

• pathology of the brain function;
• thrombotic lesions;
• decrease in the amount of circulating blood;
• infarction of children;
• comatose stun;
• death.

  Classification

  There are a number of criteria, behind which it is possible to develop types of acidotic standards.

  Mechanism of development of transferring new options:

  • Respiratory acidosis (scho winyk through increased carbon dioxide instead of in vitro);
  • nonrespiratory acidosis;
  • acidosis of malignant genesis.

  Non-respiratory acidosis can also be caused by:

  • visual (as a result of pathology of metabolic pathology through the breakdown of the functional state of the visual system);
  • metabolic (develops with accumulated endogenous acid metabolites in organisms);
  • Exogenous (winyk through an increase in the concentration of acidic metabolites, yake, in his own heart, has grown through a superbly reliable way into the organism of singing products).

  Acidosis is also classified by the value of the acidity indicator of the middle:

  • decompensations;
  • subcompensated;
  • compensation.

  Even though the indicator of acidity is within reach of the minimum permissible values ​​(lower than 7.24), it can lead to denaturation of proteins in the tissues of the body, ruining the blood cells, bending the cells, pathological changes the function of enzymes, which, in the end, can be brought to the point of unhealthy inheritance right up to the bend.

  cause

  

  Acidosis is a pathological camp and is not classified as a disease. Winning is the result of the action on the organism of ethological officials, up to which are:

  • the evil of children and hunger;
  • shkіdlivі calls - implantation of alcohol and chicken;
  • otrєnnya;
  • pathology of the functions of the intestinal tract;
  • metabolic damage (diabetes, fever, pathology of blood circulation);
  • vinoshuvannya ditini;
  • oncological processes;
  • feverishness;
  • pathology of the visual system;
  • hypoglikemichnistanu;
  • lack of living with sourness at shots, anemic camps and pathologies of the heart-vascular system;
  • overwhelmingly vivedennya bicarbonate;
  • welcome lykarsky zasobiv(Calcium chloride, salicylates);
  • pathology of the mental system.

  symptoms

  Symptoms of this disease can be easily differentiated as signs of other pathologies. Prior to the manifestation of the main symptoms, take into account:

  • vomiting and boring;
  • pidvischennya stomatologic organism;
  • tachycardia;
  • zadishka;
  • p_advischennya arterial vise;
  • the deterioration of the functioning of the nervous system (loss of evidence, I’m stunned, spoiled, unrepentant, caused by the need for sleep);
  • Signs of shock.

  Easy forms of pathology can and do not develop a clear clinical picture.

  diagnostics

  In the quality of diagnostic procedures with a wide range of vicissitudes:

  • assessment of blood gases; for the whole roof to be taken from the promenade artery, venous roof - only in times of unhappiness to the fence of the artery;
  • the value of the pH of the indicator in the section;
  • The establishment of the level of electrolytes in the blood of syrovats, which allows the differentiation of types of acidosis.

  It is also a good idea to look around and collect anamnestic tributes, so that you can help with the established cause of the pathological camp.

  

  lykuvannya

  So, as acidosis of wickedness by pathologies of bagatokh systems, then for yogo lykuvannya, persh for everything, it is necessary to pay attention to the main reason and to straighten zusillia on її usunennya. To be therapeutic, come in to get used to the main ailments.

  With metabolic acidosis, therapy is guilty of including the introduction of any kind of marriage for the additional help of an internal infusion... The important form of acidosis is guilty of being stopped by the signs of the drug, as it is to replace sodium bicarbonate in your warehouse. Infusion and nutritional formulation of the preparation to adjust the level of the water indicator to the necessary values. Also, bicarbonate must be added to glucose infusion abo physiological sodium chloride, the proportions start by the metabolic steps.

  When you show curved signs I'll become sickly can be assigned symptomatic therapy... As the acidotic pathology of the winicle is a result of getting into the body of toxic speech, it is necessary to survive the visits for this event. In some cases it is possible to know the dialogue.

  Varto mean that it is important to see the main pathology, yaka has experienced the development of acidosis.

  If you don’t put down the ethological factors, the acidotic stagnation can be known, but it is deeply infused into the function of all systems internal organs... It is necessary not only to normalize the pH of the middle, but also to speed up the reason, as the increase in acidity in the middle of the body has occurred. It’s not possible to allow the unique inheritance of inherited inheritance, to some of the important pathologies - shocks, I’ll become, as well as a lethal result.

  prophylaxis

  Determination and development of acidosis can be detected, how to lead correct image life. It is also not a matter of admitting situations when there are any potential for disruption of metabolic processes throughout the body. It is possible to reduce the amount of acidotic stamina, even if you take a number of calls:

  

  • to live a sufficient amount of birth;
  • control over the quality of water for pitt, and start indicators of water quality;
  • sklasti korektny ratsion kharchuvannya;
  • free of charge metabolic degradation;
  • engaging in physical culture, as a rule, the blood circulation of all organs, and also to bring the functioning of the mental system to the norm.

  forecast

  With free diagnostics and indications of correct therapeutic approaches, the prognosis of the result of acidosis we can be friendly... In the case of a neglected camp, I can experience a number of serious accelerations, to the point of shock and coma. Acidosis can lead to a lethal result in children who are sick. It is important for that to carry out the necessary diagnostics on a daily basis, come in, I will help you, I’m guilty of turning the given pH indicator back to normal.

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zm_st

Acid balance is one of the most important indicators of health. As a rule, in the process of living in the body, a lot of acid is formed, which can be quickly transported through the legends or from the cross, then. When the balance is damaged, acidosis can occur - a stagnation, with any acid it accumulates (accumulates) in the tissues and burns. Often a pathology occurs when there is a lack of minerals in older adults and children. The disease is characterized by a change in the acid-puddle balance in the range of a decrease in the water pH indicator and a decrease in the acidity of the middle.

cause

Acidosis is not a disease, but a deprivation of the organism, a deterioration of the acid-puddle balance, which is caused as a result of a lack of absorption and oxidation of organic acids. As a rule, the production of products with normal robotic organisms is quickened. When there are deyaky ailments and stinks, the stench goes everywhere. The most common causes of acidosis are:

• dyshally lack of pulmonary inflammation (pneumonia), emphysema (pathological enlargement of the distal bronchial spaces), hypoventilation (small surface dichannel);
• evil new affirmations;
• hunger, child;
• ominous spirits;
• hypoglycemia (decrease in blood glucose level);
• nirkova lack of;
• kurnnya;
• loss of appetite, loss, damage to the robot and the intestinal tract ( shlunkovo-intestinal tract);
• vagіtnіst;
• znevodnennya organizmu;
• otrunnya with shkidlivy speeches;
• kisneve hunger (with myocardial infarction, heart failure, anemia, shock);
• the loss of bicarbonate (acid salts of carbonate acid) with nirkas;
• vikorystannya drugs (calcium chloride, salicylates and іnshikh);
• I will become an organism, I will provoke a destructive metabolism (lack of blood circulation, diabetes mellitus, I will become hot).

see

Acidosis for their walks raises into: nonrespiratory (such a camp is filled with overly non-volatile acids), respiratory (gas acidosis) develops through inhalation of a high concentration of CO2 (carbon dioxide) and changes in types of acidosis (vicinities). Non-respiratory (non-gas) species can also have its own classification:

1. Exogenous. The standard for the increase in the concentration of acids, as it is informed by the necessary ideas in the organism of the great number of speech cells, is transformed during the metabolism in acid.
2. Vidіlnoї. It develops in case of impaired function of vivennya to the organism of non-volatile acids. Often seen when nirkova lack.
3. Gostria metabolic acidosis. The most common type of pathology, which is characterized by the accumulation of endogenous acids in the body as a result of a lack of connection abnormalities. Addressed to:

• lactic acidosis, develops through an excess in the body of lactic acid;
• hyperchloremic, in case of a deterioration of the acid balance through high chlorine in the blood plasma;
• diabetic, it appears as an acceleration of diabetic diabetes due to the presence of ketonemia (great amount of acetone in the blood) and hyperglycemia (reduction of glucose levels in the blood).

The water indicator can be infused into the acid-water balance, that is, at a norm of 7.25 - 7.44, the pH level in the body reaches low (less than 7.24) or high (more than 7.45) indicators of denaturation of bile. That is, the waste of natural powers), the decrease in the function of enzymes and the ruining of the clitin - such a camp can lead to the collapse of the body. Acidosis after the level of the water indicator pH is classified as:

1. Compensating for acidosis. The deterioration of the pH of the blood is recorded in the lower limit of physiological norms - up to the mark of 7.35. Symptoms are often seen.
2. Subcompensations. Zsuv in the "sour" side - pH 7.35-7.29. I can show arrhythmia, badness, blues, diare
3. Decompensated acidosis. The decrease in blood pH is less than 7.29. At the same time, there is clearly a turn of the damage from the side of the herbal system, heart, brain.

symptoms

Manifest a disturbed balance in the body of people and smoothly respond to the symptoms of ailments. As a rule, with a mild form of acidosis, people cannot think of a substitution for the acid-puddle balance. An accurate diagnosis can be made for that. additional information fahіvets... hocha є Signs of acidosis in humans:

• short-term blues, nudota;
• loss of evidence;
• zagalne nezduzhannya;
• zamorochennya;
• heart arrhythmia (loss of rhythm, frequency and speed of heart);
• zadishka;
• p_advischennya arterial vise (arterial vise);
• drowsiness;
• growing stunned
• making the sertsebitty stronger;
• baldness;
• entanglement of property;
• shock stun;
• hyperpnea (increase in frequency and glybini dichannya).

Have children

As a rule, acidosis in children occurs with a great burning of fat as a result of a daily intake of carbohydrates. It often happens that a child is diabetic, or with a wrong harassment. The other reasons for the deterioration of the acid-puddling stun in children are infestation, nirkova deficiency, rottenness in the intestines, Addison's ailment. the main symptoms of acidosis in ditini are inflicted:

• waste of appetite;
• blasphemy;
• adjustments of the central nervous system (central nervous system);
• hastened up the dikhannya;
• stupor;
• deterioration of peripheral microcirculation (blight, marmoriness of shkirny curves);
• problems with slag;
• carrying, blues, scho to produce until hot weather;
• in diabetics - a characteristic rotten smell from the mouth;
• head b_l;
• temporal temperature.

Great toxicity is the main sign of acidosis, which, as a rule, rarely occurs in newborns. In case of metabolic oversight, the deterioration of the acid-pool balance becomes irregular and irregular in malukovs. In case of respiratory distress syndrome (dyshnoy deficiency), when an important type of acidosis is supervised, the child's behavior becomes paradoxical - the pendulum-like hand turns from the lung to the healthy side in opposition and back.

diagnostics

When any symptoms of deterioration of the acid-puddle balance appear, people will go back to the lick. Liche fahivets can make an accurate diagnosis and sign ineffectively lіkuvannya... For tsyogo the doctor can indicate the advanced diagnostic methods:

• analysis of blood on syrovatkovy elektrolyti (shelter is taken from the artery);
• analysis of the pH value in the section;
• analysis of gas storage(Taking arterial blood from the exchange artery on the wrist is carried out, venous blood does not allow for the exact value of the pH values).

As a rule, all analyzes of blood (at the level of sirovatkovyh electrolytes and gas storage) show both the manifestation of the damage itself in the body, as well as the ith type (metabolic, respiratory and іnshі). Often, for the identification of factors in the diagnosis of acidosis, the doctor can prescribe additional diagnostic methods (analysis of the section, ultrasound diagnosis).

lykuvannya acidosis

In addition, since the development of acidosis is overwhelmed by the damage to the robotic systems of the body, I will begin to develop this before the therapy of the main ailment or dysfunction, which provokes the acid-puddle balance. Acidosis, be it of any kind, can lead to critical organisms, so it is necessary, when symptoms appear, to turn up for help to the fakhivtsya. Yak rule Correction of important forms of pathology of transmission:

• strengthening the buffer hydrocarbonate system;
• polishhennya legenevoy ventilation;
• Usunennya hypoproteinemia(Decreased concentration of blood in blood plasma);
• normalization of hemodynamics: weakening of hypovolemia (change in blood volume), renewal of microcirculation;
• polishing of oxidative processes by means of introduction of glucose, Pyridoxin, ascorbic acid, Tiamin, Riboksin, Insulin;
• correction of electrolytic exchange;
• Usuneniya provocative factor;
• polіpshennya nirkovy blood flow.

Symptomatic treatment of ailments is caused by uvazi in the middle of sodium bicarbonate (soda), ryasne pittya, inappropriate sympathetic signs (nudoti, nezduzhannya, arrhythmias). When discharged, drugs are recognized, such as vivodat toxins from the body, in important vypadnyh vikonutsya dializ (purification). In the event of a loss of peace, it is necessary to enclose the implantation of the bile. Drug treatment including vicorystannya to calcium carbonate.

For the treatment of metabolic type of degradation, use Nikotinova and Glutamic acid, Cocarboxylase. at gostrich forms acidosis will change the strength. Dimephosphon is often used for the correction of the pathological stun. When lactic acidosis is lactic acidosis, lactic acid dichloroacetate is vicious, which activates a complex of enzymes. In addition, the sick person needs to get the correct and balanced food intake, taken from alcohol and alcohol.

liveliness

With the help of a prophylactic, show the deterioration of the acid-puddle balance є vzhivannya healthy їzhі. One-sided eating is the main reason for such a pathological camp. Tse, as a rule, perevazhanya in ratsioni confectionery, bakery, meat virobes. want one correct eating Insufficiently, lіkarі to cheer up and turn on the peace of mind's activity. aje sports navantazhennya Significantly paint the ventilation of the legends, that is, there is a great amount of acidity in the body, which is responsible for the metabolism of acids.

To restore the balance і fight against acidosis if you live longer, mineral non-gas water і include in your races the following products:

• lean meat;
• Greek, porridge;
• herbs, green tea;
• fresh berries, fruits, vegetables;
• whole cereals;
• rice vidvar.

When lіkuvanni acidosis slіd forget about rich broths, sour borscht, marinades, sheep gostrich snacks. It is necessary to interconnect the life of high-quality carbohydrates, so that in the process of their absorption, a great amount of acid is formed. Observed products:

• potatoes;
• vipichka, malt;
• macaroni;
• fatty fats;
• gas drinks;
• canned food;
• cowbasa, sausages;
• alcohol;
• black tea, kava;
• chips, croutons.

prophylaxis

The breakdown of the acid-puddle balance can be unique, as a quest for food, more walks on new occasions and changes in shkіdlivyh ringtone(Courinnya, alcohol). Besides, for the prevention of acidosis, you need to take the following recommendations:

• free of charge, be it metabolic damage;
• in the ratsioni guilty of handling the products;
• it is necessary to drink at least two liters of pure water;
• when you go in for sports, you need to polish the blood flow of all organs and bring back to normal the work of the mental system;
• vipiti roschin sodi can be used for a shrewd nobility of symptoms;
• demand control drink water and the pursuit of rivne zhorstkosti (populations of minerals).

Video

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- the whole process of acid-pool concentration, which is characterized by a change in the concentration of bicarbonates on the basis of the normal acid concentration in the plasma. The main signs are a lowering of the pH of the arterial blood to the level of 7.35 and lower, the deficit of water levels by more than -2 mmol / liter, normal or partial pressure of carbon dioxide. It is clinically manifested in the reduction of myocardium, the dichal center, the decrease in sensitivity to catecholamines. Diagnose at the presentation of the results of laboratory inoculation of indicators of acid-base balance. Specific treatment is the infusion of buffer solutions.

ICD-10

E87.2 P74.0

Country houses

Metabolic acidosis (MA) is an acidemia - a stun, due to the change in activity of biologically significant bins on the acidic acid base level in the sour side. To develop in the event of a heavy interruption of somatic ailments, deyakie otruєunnyas, shocks, be it any kind of procrastination. Pomirna acidemia is not supervised by clinical symptomatology. In case of a weakened cause, the normal camp of the inner middle is renewed without medical involvement. Important acidosis can lead to recovery from BPIT through high rhiziku wild and heart-and-heart catastrophes. Patients will require continuous monitoring of life, important indicators, daily, and sometimes even blood sampling. laboratory dosage.

cause

The reason for the acidemia is the hyperproduct, or the reduction of the acid levels, as well as the strengthening of the blood components. Metabolic acidosis occurs in all cases of shock, clinical death and postresuscitation ailments. Besides, pathology can develop in case of disease-free pathological processes of a therapeutic and surgical profile. False from the main deterioration of acidification can be caused by lactate or ketone bodies. I will make the following types of data:

• lactic acidosis... Winning at the strength of the processes of anaerobic glycolysis in myases. Important forms of lactic acidosis are observed in patients with swollen tissue hypoxia, dysfunctional deficiency, decreased systolic arterial vise below the level of 70 mm Hg. Art. Spostering with sepsis, hypovolemia, synthesis of a great amount of D-lactate intestinal microflora. The physiological reason for the failure of the ACS is the active physical activity of the robot, including busy with important athleticism. The process of not being able to get good results and passing through independently, without a bar, in order to relax the words.
• ketoacidosis... Є a symptom of somatic illness. It is susceptible to diabetes mellitus, chronic and non-alcoholic deficiencies, poisoned by alcohol, methyl alcohol, ethylene glycol, salicylates, damaged liver functions. In addition, the concentration of ketones tends to move at the terminal stage of shock, with the development of multiple organ deficiencies.
• vrata pіdstav... It is very common for a number of ailments of the shlunkovo-intestinal tract: trivial diarrhea, intestinal fistulas, intestinal derivation of the section. Staying as a result surgical operations, In the course of a healthy flow of blood vessels into the intestine in case of imperfection sectional mikhura... Sicha is a water indicator at the level of 5-7, so that we are sour in the middle. When it gets into the intestine, it neutralizes the intestinal pool.

pathogenesis

Metabolic acidosis should be reduced to a decrease in the concentration of HCO 3 and an increase in the amount of Cl -. They actively replace the calories in the cells with water and water, and increase the amount of K + in plasma. When there is a lack of deficiency, excess calories are seen from the cross-section. At the same time, in the blood, it is close to normal, the internal hypocalypse is formed. In case of surge arrester, the plasma should be replaced by an increased number of K + ions. Small amounts of suv are compensated for the breakdown of buffer systems: bicarbonate, phosphate, hemoglobin, bilkovo. The stench is reversible to ring protons, homeostasis is susceptible, protections of systems appear insufficiently in massive acidosis. A decrease in pH is observed, as a result of the conformity of amphoteric plants. The activity of hormones, neurotransmitters changes, the function of receptor devices deteriorates.

Classification

Існ кілька clasifіkatsіy alkalemiі. One of the broadest criteria for the choice is anion of growth - a difference in the concentration indicators of K +, Na + and CL -, HCO 3 -. The normal level is 8-12 mmol / liter. It is also an indicator of savings, to talk about alkalosis with a normal anionic dyro, change to indicate a change in the concentration of unmeasurable cations Mg +, Ca +, or about the change in the level of phosphates, albumin, acids. Prior to the basic practice of victorious classification for the level of compensation for MA:

1. compensations... It protects asymptomatically, leading to homeostasis, trying to develop active robotic and compensatory mechanisms. The pH of the savings is at 7.4, the deficit is zero, the partial squeeze of CO2 is adjusted at 40 mm Hg. Art. Reveal at the trivial robots of the great obsyagu m'yazovoy fabric, And also on the cob stage of internal disease. Medical correction is not required.
2. subcompensated th. The water indicator will settle down in the boundaries of the norms or decrease slightly (7.35-7.29). A small deficit is indicated (up to -9). pCO2 decreases for the rate of compensatory hyperventilation, the protein does not have a value of 28 mm Hg. Art. Vinic nonspecific mild key picture... In the presence of buffer ridin, there is no need.
3. decompensations... The pH drops below 7.29, the BE deficiency is down to -9 mmol / liter. Chi will not be compensated for the rakhunok legenevoy hyperventilation. The partial vise falls down to 27 mm Hg. Art. or lower. The symptomatology is often flared up, and the self-esteem of the sick person grows. required unavailable help from the storage of buffer connections.

Symptoms of metabolic acidosis

Compensation or subcompensation is asymptomatic and asymptomatic. When the deficiency of hydrocarbonates is more than -10, the water indicator is lower than 7.2, there is a compensatory hyperventilation. Vona is manifested in the form of a great general dichotomy. In the world of decompensation, I will begin to develop the spirit of Kussmaul at the patient. Chronic acidosis in children should be produced before growth and development. іnshі key signs lie in the main pathology. There may be diarrhea, verbiage of shkiri, polyuria, good luck, Zamorochennya. In the anamnesis of the presence of a trivial hunger, intake of high doses of salicylates, ethylene glycol, methanol or ethanol, the presence of sugar diabetes, intestinal problems, chronic deficiency.

Important metabolic deterioration of the potential for hypotonia. The reaction to the introduction of freshwater aminiv is reduced abo vidday. There is a decrease in the speedy health of the myocardium, compensatory tachyarrhythmia. Plasma hyperkaliyaemia on the other side of the deficiency becomes the cause of fibrillation of the anterior heart (flashing arrhythmia). There are signs of impaired atrioventricular conductivity. Patsinti skarzhitsya on the beetle in the breasts, sercebitty, marriage of a god. With an objective look, the shkira blida is abnormally cyanotic, cold to the dot, the pulse is arrhythmic, weak reminiscence and spasm, dizzy, glib, noisy. Mossy development of encephalopathy.

accelerating

It is important to counteract metabolic acidosis at the thermal stage of the reaction to the dichotomy of the center. For the change of hyperventilation, a weak surface is coming. Hypoxia of the brain develops, which can be produced to the point of loss of quality and coma. The activity of nirok, stove, and polyorganic lack will collapse. Progression of the deterioration of the nerve-myazovoi provinces, which becomes the reason for the breakdown of the efficiency of all systems to the body. Some of the atrial arrhythmias are widened to the lugs. Fibrillation of the last is promoted, clinical death is diagnosed.

diagnostics

MA diagnostics in VRIT patients should be performed by an anesthesiologist-resuscitator doctor. In the presence of chronic somatic ailments, it is necessary to consult the university faculty: endocrinologist, surgeon, nephrologist, hepatologist. Chronic metabolic acidosis can be detected by drug home practice on outpatient reception... Diagnosis will be established at the end of the next days:

• physical... It does not allow for the exactness of the appearance of changes, but there are some signs of damage to the back of nonspecific and can be developed in the event of impaired pathological processes. However, a general picture is given for the analysis of acid-base balance and electrolyte plasmas.
• laboratory... Є the basis of a diagnostic joke. Acidemia is diagnosed in case of a low pH value, deficiency of hydrocarbonates, low partial pressure in carbon dioxide. To determine the type of acidosis, carry out an assessment of the anionic difference. To clarify the mechanism, it is possible to introduce anionic diri not only in plasma, but also in the section.
• hardware... Zd_ysnyuєtsya for the detection of the main disease, as well as for the diagnosis of errors. On the EKG, a sharpened T wave, an expanded QRS complex, a P wave, large-wave or small-wave fibrillation in front of the heart, nervnomirni intermediate between the slurry complexes are indicated. In case of stagnation in great number There may be an ultrasonic signal of the improvement of the stove, the spleen, the purchase of the birth in the black empty.

Treatment of metabolic acidosis

MA therapy without any reasons is not adequate, it is based on the appearance and treatment of the main illness. With diabetic ketoacidosis, it is necessary to correct the amount of sugar in the blood, with lactic acidosis - to eliminate tissue ischemia and hypoxia. In case of shock camps, patients are shown to come in. Likuvannya of the first cause of the acidemia is carried out in parallel with the normalization of the acid-puddle storage of the inner middle. The following methods can be used for storing:

1. medication... In case of decompensated forms of ailment, the correction should be made by the way of infusion internal introduction of sodium hydrocarbonate. In the middle of the buffered drops, it is not vicious. Can be transfused with lactasol, which is metabolized in ovens with HCO3 solutions. renewal electrolyte balance with infusions of Disol, Acesol, Trisol. In case of hypoproteinemia, transfusion of blood cells is indicated. The normalization of oxidative processes in tissues is vibrated by the sign of polyvitaminic complexes, pantothenic and pangamic acids.
2. apparatus... It is necessary for the accelerated interruption of the process for the correction of life-important functions. Dichally lack of є is shown for the transfer of the patient to the piece ventilation of the legends, the decrease in the function of nirok vimagan carrying out hemodialysis. With a decrease in the arterial grip, the device (through the іn'ktomatіv) is infused with vasopressors. When fibrilating slunches, electropulse treatment, indirect massage of the heart.

Forecast and prevention

It is too much of a problem to lie in the main pathological process and the possibility of this general weakening. In order to address the causes of acidic acid breakdown, it is easy to fix the problem at the stage of decompensation. Medicines to reserve the deficiency of hydrocarbonates while saving the ethological factor of acidification does not allow the achievement of a stable normalization of the water indicator and BE (indicator of excess / deficiency of HCO 3). Prophylaxis of polyagons in the quick treatment of processes, which are the cause of acidosis, regulation of blood flow, undergoing hemodialysis procedures for chronic nircovymic deficiencies. In the minds of VRIT, metabolic acidosis appears and corrects on early stage in case of generic vivchenny indicators of acid-puddle balance.

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Metabolic acidosis is characterized by accumulation in organisms as a result of impairment of the metabolism of supra-peaceable acids (non-volatile) acids.

The main reasons for the development of metabolic acidosis.

Adjustment of acids:

• keto acids in case of sugar diabetes, trivial hunger and alcohol sp'yaninny;
• lactic acid for shots and hypoxia tissue;
• hydrochloric acid in case of enhanced catabolism ( period of operation, Trivale hunger);
• the absorption of chlorides in patients with uretero-intestinal anastomosis has been increased.

Damaged vivedennya acids (uremic acidosis):

• chronic glomerulonephritis;
• the nirka is firstly or repeatedly wrinkled;
• shock nirka.

Nadlishkova Vrata to hydrocarbonate:

• fistulas of two-fingered or small intestine, zhovnoy mikhura;
• diarrhea;
• ulcers colitis.

Abovemіrne introduction to sodium chloride:

• iatrogenic damage, tied with a superworldly infusion series of roses.

Diagnostics of metabolic acidosis is based on the preliminarily indicators in the acid-pool. If in some cases, especially in ailments with ketoacidosis, a significant decrease in the pH level is manifested in a bad way (Kussmaul's dichotomy), which is corrected for a decrease in the concentration of carbon dioxide, and the diagnosis of the deterioration of the acid-base station in the can. When the parameters in the acid-puddle plant are reached on metabolic acidosis, a decrease in BE< -2,3 и НСОЗ < 22 ммоль/м. Ниже приведены примеры компенсированного и декомпенсированного метаболического ацидоза.

In case of compensated metabolic acidosis, no special medical visits are required. In case of decompensation with the help of pH adjustment by plasmas, it is necessary to introduce additional solutions. Sodium hydrocarbonate is used to increase the capacity of the hydrocarbonate buffer with plasmas. A dose of 1 molecular weight (8.4%) is required to be paid according to the formula:

BE x mas tila x 0.3

As a result of the memory, when the introduction of sodium bicarbonate is supervised, it is necessary to correct the parameters of the parameters. An oversized amount of sodium bicarbonate can lead to the development of iatrogenic alkalosis.

For the correction of metabolic acidosis, trometamol can also be used. The introduction of the drug is tied with a bandage and vivodit through nirki. Part of the drug penetrates through the cell membrane in the cell, allowing the therapy of internal acidosis. It is possible to designate it for you only when normal function nirok. The introduction of sodium bicarbonate and trometamol, the therapy of metabolic acidosis is to blame for the correction of low CO syndrome, the optimization of acid delivery to the organs and tissues, the correction of the water-electrolyte balance, carbohydrate fullness

Savel'ev V.S.

surgical ailments