水电解质酸碱平衡和紊乱.ppt

* * Clinical features of metabolic acidosis Respiratory : Kussmaul’s respiration. Cardiac : hypotension, standstill Bone disease * * Diagnosis of metabolic acidosis Step 1: Confirm the diagnosis requires ? pH + ? [HCO3-] Step 2: Assess the degree of compensation. 10 mmol/L ? [HCO3-] ， 12 mmHg ? PCO2 Otherwise, respiratory disorders? Step 3: normal AG or elevated AG * * Treatment of metabolic acidosis 治疗潜在疾病 威胁生命情况的紧急治疗 Alkali therapy Prevent and treat electrolytes disorders * * Metabolic alkalosis * * METABOLIC ALKALOSIS pH 7.45. Serum HCO3 PaCO2 HCO3 elevated 外源性碱摄入 胃肠道丢失酸 肾脏丢失酸或