How to see respiratory acidosis?
summary
The acid-base balance in the human body mainly depends on the regulation of the lung and kidney, but more attention to their own body, not to check, eventually developed into a more serious disease. The former mainly maintains the balance of CO2 and HCO3, while the renal regulation depends on the acid excretion and alkali retention of renal tubules; Today, let me tell you about respiratory acidosis?.
How to see respiratory acidosis?
First, 15-20 ml / kg / h 0.9% sodium chloride was given intravenously in the first hour of rehydration, and then adjusted according to the degree of dehydration and blood sodium level: severe dehydration - 1000 ml / h 0.9% sodium chloride; Moderate dehydration without hyponatremia - 0.45% sodium chloride 250-500 ml / h; Moderate dehydration combined with low sodium - 0.9% sodium chloride 250-500 ml / h.
Second: the rapid correction of potassium supplement acidosis is the transfer of blood potassium into cells, resulting in hypokalemia. Therefore, potassium ion should be supplemented at the same time of correcting acidosis. Unless the serum potassium level is higher than 5.2 mmol / L, the acidosis should be corrected and potassium ion should be supplemented at the same time; When serum potassium was lower than 3.3 mmol / L, potassium supplement was needed before insulin treatment;
Third, magnesium supplement: if the blood magnesium level is lower than 0.5 mmol / L, magnesium ion supplement is needed. The first 24 h supplement is 8-12 g, and then the dose is 4-6 g / D for 3-4 days;
matters needing attention
1. If the correction speed is too fast, the lung compensatory hyperventilation will be inhibited, and PCO2 will easily rise, while CO2 will easily pass through the blood-brain barrier and aggravate the central symptoms; The dissociation curve of hemoglobin shifted to the left, making it difficult to release oxygen and aggravating tissue hypoxia. 2. Acidosis can inhibit the formation of endogenous acids. Correcting acidosis too quickly may increase the formation of endogenous organic acids and aggravate acidosis. 3. To quickly correct acidosis, we should pay attention to the prevention of convulsions caused by low blood calcium.
