What symptom can alkalescent acidosis have?
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.
What symptom can alkalescent acidosis have?
1. Shallow and slow breathing is the compensation phenomenon of respiratory system to alkalosis. With the help of shallow and slow breathing, it can increase the PCO2 in alveoli and increase the denominator of [bhco3] / [hhco3], so as to reduce the ratio change (stable pH value) due to the increase of molecules.
2. Mental symptoms: restlessness, excitement, delirium, drowsiness and coma in severe cases. Respiratory acidosis is mainly manifested as shortness of breath, dyspnea, blurred consciousness or coma, people will be more irritable. Respiratory acidosis may be caused by sedatives or anesthetics, upper airway obstruction, respiratory myasthenia or lung disease.
3. Neuromuscular excitability increased, including tetany, tendon hyperreflexia, etc. Metabolic bone disease may occur in the treatment of metabolic acidosis, which is mainly caused by the long-term calcium out of bone; Metabolic acidosis can also decompose a large amount of protein, resulting in malnutrition; In addition, metabolic acidosis is often accompanied by hyperkalemia. However, it should be noted that some patients may also have hypokalemia, such as diabetic patients and patients with diarrhea. When treating them, we should observe the potassium content in serum more, and if there is potassium loss, we should supplement potassium in time.
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. 3. 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.
