钾代谢障碍 酸碱平衡紊乱幻灯片.pptVIP

3) Compensation: Buffer system and cell4) Manifestations: Headache, cardiac arrhythmias and neurologic abnormalities.  Neurologic manifestations may be more prominent in respiratory acidosis than in metabolic acidosis. “CO2 narcosis” The mechanism: (1) CO2 crosses the blood-brain barrier relatively easily, and can dilate the blood vessels in the brain and lead to brain edema.  (2) CO2 can also decrease the pH of the cerebrospinal fluid, and make depression of neural function, like weakness, confusion, paralysis, stupor and coma. 5) Laboratory findings ↓pH, ↑ PaCO2,  ↑HCO3- if there is compensation of kidneys (chronic).  3. Metabolic alkalosis 1) Concept: Metabolic alkalosis refers to a primary increase in base bicarbonate, the pH elevates.  2) Causes: (1) Decrease of acid E.g. vomiting (Ileus: intestinal obstruction). (2) Increase of base E.g. antacids, transfusion with citrated blood, hyperaldosteronism. Saline-responsive alkalosis and saline-resistant alkalosis 3) Compensation4) Manifestations Alkalosis can cause increased excitability of nervous system, like hyperactive reflexes, muscle hypertonicity, tetany etc. 5) Laboratory findings ↑pH, ↑HCO3-,  ↑ PaCO2 if there is compensation of respiratory system. 4. Respiratory alkalosis 1) Concept: Respiratory alkalosis is defined as an increase of pH induced by primary decrease in plasma [H2CO3]. 2) Causes: Hyperventilation  E.g. anxiety, hysteria, fever, early salicylate (aspirin) toxicity, misuse of mechanical ventilation. 3) Compensation4) Manifestations Tetany 5) Laboratory findings ↑pH, ↓PaCO2,  ↓HCO3- (depend on the normal renal function). 5. Mixed acid-base imbalancesConcept: Two or more primary acid-base imbalances exist at the same time. Bacterial pneumonia→ respiratory acidosisPatient Diarrhea→ metabolic acidosis In this mixed imbalance, the pH is