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Complications: 1. Respiratory acidosis metabolic acidosis showed significantly higher PaCO2 and HCO3-decreased significantly marked increase in the ratio of the two lead to severe acidosis. Common reasons are as follows:
In cardiac arrest the most typical of severe pu


lmonary edema. Excessive use of salicylate poisoning with sedatives and on the basis of the original lung disease sepsis or renal failure may also occur.
Cardiac arrest or acute pulmonary edema, the lungs can not be discharged when the large accumulation of CO2 to CO2 produced respiratory acidosis in vivo circulation disorder caused when a large number of organizations can not perfusion hypoxia and lactate production, the formation of metabolic acidosis. Disorders and central lesions of the ventilation PaCO2 value can not drop, the pH value can be significantly reduced. Cardiopulmonary resuscitation should be immediately treated to restore airway patency, ventilation is not smooth in the former can not be over-infusion of NaHCO3, the reasons mentioned above another, NaHCO3 injection of hypertonic induced hyperlipidemia and to facilitate the K into the cell from the extracellular and various other changes can increase the risk of disease.
2. Salicylate poisoning are mostly found in the elderly and those suffering from joint pain can produce acidosis as a result of chronic pain increases with sedatives or strong analgesics can produce suppression of central metabolic acidosis caused by respiratory acidosis increases. Chronic obstructive pulmonary disease can generally be increased by hematocrit, the total oxygen-carrying capacity increased oxyhemoglobin dissociation curve to the right, etc., the normal compensatory oxygen to tissues. When combined with severe anemia, such as sudden gastrointestinal bleeding, hypotension, cardiac arrhythmias can occur hypoxia, lactate production increases, there metabolic acidosis plus respiratory acidosis. If infection with renal dysfunction, metabolic disorders are more serious degree of increased acidosis.
3. Respiratory acidosis with metabolic alkalosis which is more common clinical acid-base balance of a mixed type disorder seen in patients with chronic obstructive pulmonary disease combined vomiting; chronic pulmonary heart disease, heart failure using potassium row of diuretic therapy, etc. At this point changes in blood pH, acidosis and alkalosis depends on the strength, such as the extent appropriate, the pH value of the constant offset each other; such as pH value is slightly stronger party to increase or decrease; PaCO2 and plasma HCO3-concentration was significantly increased, and exceeded the degree of change between the two should meet each other, the scope of compensation.
4. Acute respiratory acidosis hyperkalemia caused by ventricular fibrillation, can be 60 ~ 100ml 5% sodium bicarbonate in 5 ~ 10min intravenous infusion in the transfer of K to the cells.

Over
Metabolic acidosis (general surgery) is mainly due to the body caused by HCO3-reduction, can occur in diarrhea, intestines, pancreas, biliary fistula, fever, dehydration, peritonitis, shock, renal failure and so on. Is the most common surgical disorder of acid-base balance. The symptoms of primary disease symptom is easily overshadowed by increased acidosis is often the primary disease, so in the treatment of primary disease, we must promptly correct the acidosis.
Symptoms:
1. Breathing deepened to speed up, can be a rotten apple. 2. Fatigue, drowsiness, coma. 3. Facial flushing, blood pressure, heart rate fast.
Diagnosis based on:
1. Diarrhea, intestinal fistula, pancreatic fistula, biliary fistula, peritonitis, shock, diabetes, kidney failure and other medical history. 2. Facial flushing, breathing deepened to speed up, there are rotten apple for the outstanding performance. 3. Blood PH, HCO3-reduced.
Treatment:
Treatment principles 1. To eliminate the cause, correct water and electrolyte imbalance; 2. Add basic drugs, to correct acidosis.
Drug Principles 1. Clinically first with 0.9% NaCl, 5% GS solution to correct water and electrolyte disturbances. Self-correcting mild acidosis can not be corrected by re-use of basic drugs. 2. Jiyong sodium or those with respiratory acidosis can be 3.6% THAM.
Prevention of common sense:
The treatment of metabolic acidosis, is the root cause to remove, fill alkali is a temporary solution, it should actively treat the primary disease. Mild acidosis, and in correcting water and electrolyte imbalance to correct itself after, do not make alkaline. Should be promptly corrected with severe acidosis, alkali treatment in the meeting, should observe the clinical and biochemical re, when the symptoms improved, urine output enough, CO2CP18mmol / L or more, can not re-use of basic drugs. Metabolic acidosis, serum K can be high and dry when the correct acidosis, may appear low blood K, tetany, should pay attention to make K.


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