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Respiratory acidosis, the diseases can be complicated?
1. Respiratory acidosis showed metabolic acidosis PaCO2, HCO3-was significantly increased and decreased significantly increased the ratio of the two lead to severe acidosis, common reasons are as follows:
In cardiac arrest, severe pulmonary edema, the most typical and 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 CO2, so a lot of accumulation of CO2 in vivo, resulting in respiratory acidosis, when the organization can not cycle disorders perfusion, hypoxia resulted in substantial lactate production, the formation of metabolic acidosis, as well as ventilation disorders central lesions, PaCO2 value can not fall, so can significantly reduce the pH value, treatment should be immediate cardiopulmonary resuscitation to restore airway patency, ventilation is not smooth in the former can not be over-infusion of NaHCO3, the reasons mentioned above, the other, NaHCO3 injection caused hyperosmolar hyperlipidemia and to facilitate the K into the cell from the extracellular and various other changes, can exacerbate the risk of disease.
2. Salicylate poisoning are mostly found in the elderly and those suffering from joint pain, can produce chronic acidosis, increase in pain when the use of sedatives or strong analgesics, can cause suppression of ce


ntral produce metabolic acidosis plus respiratory acidosis , chronic obstructive pulmonary disease can generally be increased by hematocrit, the total oxygen-carrying capacity increased oxyhemoglobin dissociation curve to the right, etc., and compensatory tissue oxygen supply to normal, when combined with severe anemia, such as sudden digest bleeding, hypotension, arrhythmia, can occur hypoxia, lactate production increases, there metabolic acidosis plus respiratory acidosis if renal dysfunction, infection, metabolic disorders are more serious, heavier the degree of acidosis.
3. Respiratory acidosis with metabolic alkalosis which is more common clinical acid-base balance of a mixed type disorder, seen in chronic obstructive pulmonary disease combined vomiting; chronic pulmonary heart disease, heart failure, the use of row K of diuretics, etc., when changes in blood pH, acidosis and alkalosis depends on the strength, such as the extent appropriate, then cancel each other, pH values remained unchanged; as one strong, the pH value of the slight increase or lower; PaCO2 and plasma HCO3-concentration was significantly increased, and the degree of change between the two are to be compensated each other to reach beyond the scope.
4. Acute respiratory acidosis hyperkalemia caused by ventricular fibrillation, can 5% sodium bicarbonate 60 ~ 100ml, within 5 ~ 10min in the intravenous infusion, the K transfer 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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