Symptoms and complications of acidosis

summary

The pH value of normal people was 7.35-7.45. Alkalosis refers to the clinical situation of excessive acid loss in the body or excessive alkali intake from the body. The main biochemical manifestations are high HCO3 (> 27mmol / L) and high PaCO2. The pH value is more than 7.45, but it varies according to the compensation situation, which can be significantly too high; It can also be slightly elevated or even normal. Let's talk about the symptoms of acidosis and alkalosis.

Symptoms and complications of acidosis

Shallow and slow breathing is a compensatory phenomenon of the respiratory system to alkalosis. With the help of shallow and slow breathing, it can increase the PCO2 in the alveoli and increase the denominator of [bhco3] / [hhco3], so as to reduce the ratio change (stable pH value) due to the increase of molecules. Acidosis refers to the increase of hydrogen ion concentration and decrease of pH value due to the accumulation of acidic substances in blood or tissue. Acidosis can be divided into metabolic acidosis and respiratory acidosis. The main symptoms of acidosis in human body are headache, nausea, fatigue, chest tightness, dyspnea and so on. If the condition worsens, these symptoms will also aggravate, and even dehydration, heart rate acceleration, disturbance of consciousness and other symptoms will appear.

Neuromuscular excitability increased, tetany, tendon hyperreflexia and so on. The significant characteristics of metabolic acidosis are continuous decrease of pH value and primary decrease of plasma. Metabolic acidosis will first affect the cardiovascular system, acidosis will make electrolyte disorders, leading to arrhythmia; Secondly, it will bring pressure to the respiratory system, manifested as the aggravation and deepening of breathing; In addition, it will affect the gastrointestinal system, patients will have abdominal pain, diarrhea, nausea and vomiting.

Mental symptoms include restlessness, excitement, delirium, drowsiness and coma. If the symptoms are serious or PCO2 > 8.0kpa (60mmhg) or the respiration is inhibited due to respiratory compensation (CO2 accumulation) resulting in hypoxia, acid drugs should be used. Can take ammonium chloride orally, if the patient cannot take it orally, can use ammonium chloride intravenous drip.

matters needing attention

1. Active treatment of primary diseases, avoid long-term use of alkaline drugs, less serious alkalosis does not need too active treatment, patients with potassium deficiency can be given potassium chloride sustained-release tablets orally. 2. For patients with insufficient circulating blood volume, dextran 70 saline injection can be rapidly infused to restore effective circulating blood volume, and then normal saline or glucose normal saline can be infused to supplement the extracellular fluid volume, so as to reduce the exchange of h for Na in distal renal convoluted tubules and exert the function of HCO3 - excretion by the kidney.