ʻO Acidosis

ʻO ka Acidosis kahi ʻano i nui ka nui o ka waikawa i nā wai o ke kino. ʻO ia ka ʻaoʻao ʻē aʻe o ka alkalosis (kahi kūlana i nui ai ke kumu i nā wai o ke kino).

Mālama nā puʻupaʻa a me nā akemāmā i ke kaulike (pae pH kūpono) o nā kemika i kapa ʻia nā ʻakika a me nā kumu i ke kino. Hana ʻia ka Acidosis ke kūkulu ʻia ka waikawa a i ʻole ke nalowale o ka bicarbonate (kahi kumu). Hoʻokaʻawale ʻia ka Acidosis ma ke ʻano he respiratory a metabolic acidosis paha.

Hoʻoulu ka acidosis hanu ke nui ka carbon dioxide (kahi acid) i ke kino. Hoʻokumu pinepine ʻia kēia ʻano acidosis ke hiki ʻole i ke kino ke wehe i ke kalapona kalapona ma o ka hanu ʻana. ʻO nā inoa ʻē aʻe no ka acidosis respiratory he hypercapnic acidosis a me carbon dioxide acidosis. Kumu o ka hanu acidosis nā:

• Nā deformities o ka umauma, e like me kyphosis
• Nā hōʻeha umauma
• Nāwaliwali ka ʻiʻo o ka umauma
• ʻO ka maʻi maʻi wā lōʻihi (mau)
• Nā maʻi Neuromuscular, e like me myasthenia gravis, mustrular dystrophy
  
• Hoʻohana nui ʻia i nā lāʻau hoʻohiamoe

Hoʻolālā ka metabolic acidosis ke hana ʻia ka nui o ka waikawa i ke kino. Hiki iā ia ke hana ke hiki ʻole i nā puʻupaʻa ke hemo i ka nui o ka waikawa mai ke kino. Aia kekahi mau ʻano o ka metabolic acidosis:

• Hoʻomohala ka diabetic acidosis (i kapa ʻia hoʻi he ketoacidosis diabetic a me DKA) ke kūkulu ʻia nā mea i kapa ʻia he kino ketone (ʻo ia nā acidic) i ka wā o ka maʻi kō.
• Hoʻokumu ʻia ʻo Hyperchloremic acidosis e ka nalo ʻana o ka nui o ka sodium bicarbonate mai ke kino, i hiki ke hana ʻia me ka diarrhea nui.
• ʻO ka maʻi kīnā (uremia, acidal tubular acidosis tubal a i ʻole proximal renal tubular acidosis).
• Losis acidosis.
• Poisoning by aspirin, ethylene glycol (loaʻa i ka antifreeze), a i ʻole methanol.
• Ka make nui loa ʻana.

ʻO ka lactic acidosis kahi kūkulu o ka lactic acid. Hana ʻia ka lactic acid i nā hunaola a me nā hunaola ʻulaʻula. Hana ia i ka wā e wāwahi ai ke kino i nā haʻuki kūpona e hoʻohana ai no ka ikehu ke haʻahaʻa nā pae o ka oxygen. Hiki ke kumu ʻia kēia e:

• Kanesa
• Ke inu nui nei i ka waiʻona
• E hoʻoikaika ikaika ana no ka manawa lōʻihi loa
• Hoka kōpaʻa
• Ke kō koko haʻahaʻa (hypoglycemia)
• Nā lāʻau, e like me salicylates, metformin, anti-retrovirals
• MELAS (kahi maʻi mitochondrial genetical loa e hoʻopili i ka hana ikehu)
• Ka lōʻihi o ka nele o ka oxygen mai ka haʻalulu, ka puʻuwai ʻole, a i ʻole ka anemia koʻikoʻi
• Ka hopu ʻana i nā maʻi
• Sepsis - nā maʻi nui ma muli o ka maʻi me nā koʻohune a i ʻole nā ​​g germ
• Lāʻau make kalapona
• Hānō nui

Pili nā ʻōkuhi metabolic acidosis i ka maʻi a i ʻole ke ʻano. ʻO ka Metosis acidosis pono ke kumu o ka hanu wikiwiki. Huikau paha lethargy paha e kū. Hiki i ka metabolic acidosis koʻikoʻi ke alakaʻi i ka weliweli a i ʻole ka make.

Hiki i nā ʻōnaehana acidosis hanu ke komo pū me:

• Huikau
• Ka luhi
• Lethargy
• Pokole o ka hanu
• Hiamoe

E hana ka mea mālama ola i kahi hoʻokolokolo kino a nīnau e pili ana i kāu mau hōʻailona.

ʻO nā hoʻokolohua Laboratory i kauoha ʻia e komo pū:

• ʻImi kinoea Arterial
• Pākuʻi metabolic maʻamau (ka hui o nā hoʻokolohua koko e ana i ka pae o ka sodium a me ka potassium, ka hana o ke konā, a me nā kemika a me nā hana) e hōʻike ai inā he metabolic a i ʻole hanu ka ʻano o ka acidosis.
• Ketone koko
• Hōʻike ʻakika Lactic
• Nā ketone mimi
• Mimi pH

ʻO nā hoʻokolohua ʻē aʻe e pono ai e hoʻoholo i ke kumu o ka acidosis e komo pū:

• Pākuʻi x-ray
• CT ʻōpū
• Urinalysis
• Mimi pH

Pili ka mālama ʻana i ke kumu. E haʻi hou aku kāu mea lawelawe iā ʻoe.

Hiki ke weliweli ka Acidosis inā mālama ʻole ʻia. ʻO nā hihia he nui e pane maikaʻi i ka lāʻau.

Pili nā pilikia ma ke ʻano kikoʻī o ka acidosis.

E hana nā ʻano acidosis āpau i nā hōʻailona e koi ai i ka mālama ʻana e kāu mea hāʻawi.

Pili ka mālama ʻana i ke kumu o ka acidosis. Hiki ke pale ʻia nā kumu he nui o ka acidosis metabolic, e like me ka ketoacidosis diabetic a me kekahi mau kumu o ka acidosis lactic. ʻO ka maʻamau, ʻaʻohe acidosis koʻikoʻi o ka poʻe me nā puʻupaʻa olakino a me nā akemāmā.

• Nā hakuʻala

ʻO Effros RM, Swenson ER. Koena hoʻowahāwahā kumu. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 7.

ʻO MS, Briefel G. Ka loiloi ʻana i ka hana o ke kōpaʻa, ka wai, nā electrolytes, a me ke kaulike acid-base. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. St Louis, MO: Elsevier; 2017: chap 14.

Seifter JL. Nā maʻi kūmole. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 110.