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First, metabolic acidosis
The most common metabolic acidosis, the body of [HCO3] caused the decrease. According to whether the increased anion gap can be caused by [HCO-3] to reduce the reasons into two categories. Anion gap, also known as undetermined anion concentration, a rough estimate, normal is 8 ~ 12mmol / L, the [Na] concentration minus the [CI-] concentration [HCO3] concentration obtainedMetabolic alkalosis by the body [HCO-3] caused an increase. The reasons are: 1. Acidity of gastric juice is too much loss of metabolic alkalosis in surgical patients, the most common cause. Significant loss of acidic gastric juice, such as severe vomiting, long-term gastrointestinal decompression, etc., in fact, is the loss of a large number of H +. As in the intestinal fluid [HCO-3] failed to be from the hydrochloric acid in gastric juice and, [HCO-3] to be re-absorbed into the blood circulation, increased blood HCO-3. In addition, the loss of gastric juice and lost a lot of sodium, chloride and extracellular fluid, causing the HCO-3 reabsorption in renal tubules increased, and the compensatory sodium, chloride and water loss in the process, K + and Na exchange and the exchange of H + and Na increase, causing the loss of H + and K + too much, resulting in alkalosis and hypokalemiaRespiratory acidosis mean alveolar ventilation function, and can not be fully generated from the body CO2, resulting in blood PCO2 increase, causing hypercapnia. Common reasons are too deep general anesthesia, a sedative overdose, cardiac arrest, pneumothorax, acute pulmonary edema, bronchospasm, laryngospasm, and improper use of breathing machine, significantly affect the respiratory, the lack of ventilation, causing acute, temporary high hypercapnia. Another reason is that can cause persistent increases PCO2 diseases, such as extensive lung fibrosis, severe emphysema and other chronic obstructive lung disease. These diseases have ventilation or alveolar ventilation dysfunction - blood matching disorders, and it could lead to CO2 retention in the body, leading to hypercapnia.Mean alveolar hyperventilation respiratory alkalosis, the body smoky-generated CO2, which reduces blood PCO2, causing hypocapnia. Induced hyperventilation many reasons, there is hysteria, psychological stress, fever, trauma, infection, central nervous system disease, mild pulmonary edema, pulmonary emboli, hypoxemia, liver failure and improper use of breathing machines. Chronic respiratory alkalosis in surgical patients are relatively rare.


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