Hoʻokolohua Koko CO2

Anter

• He aha kahi hōʻike koko CO2?
• No ke aha e kauoha ʻia ai ka hōʻike koko CO2
• Pehea e lawe ʻia ai kahi laʻana koko
• Laʻana koko Venipuncture
• Laʻana koko arterial
• Pehea e hoʻomākaukau ai no kāu hōʻoia koko
• Nā pilikia o kahi hōʻike koko CO2
• Nā hopena hōʻike
• Low bicarbonate (HCO3)
• High bikarbonate (HCO3)
• Nānā wā lōʻihi

He aha kahi hōʻike koko CO2?

Kuhi ʻia kahi hōʻike koko koko i ka nui o carbon dioxide (CO2) i ke koko serum, ʻo ia ka ʻāpana wai o ke koko. Kāhea ʻia kahi hōʻike CO2:

• kahi hōʻike kalapona kalapona
• kahi hoʻāʻo TCO2
• he huina hoao CO2
• hoʻāʻo bicarbonate
• kahi hōʻike HCO3
• he serum hoʻokolohua CO2

E loaʻa paha iā ʻoe kahi hoʻokolohua CO2 ma ke ʻano he ʻāpana o ka ʻaoʻao metabolic. ʻO kahi papa metabolic kahi hui o nā hoʻokolohua e ana i nā electrolytes a me nā kinoea koko.

Aia i loko o ke kino nā ʻano nui ʻelua o ka CO2:

• HCO3 (bicarbonate, ke ʻano nui o CO2 i ke kino)
• PCO2 (carbon dioxide)

Hiki i kāu kauka ke hoʻohana i kēia hoʻokolohua e hoʻoholo inā aia kahi kaulike ʻole ma waena o ka oxygen a me carbon dioxide i loko o kou koko a i ʻole PH ke kaulike ʻole i kou koko. Hiki i kēia mau kaulike ʻole ke hōʻailona o ke kīkohola, ka hanu ʻana, a i ʻole nā ​​maʻi metabolic.

No ke aha e kauoha ʻia ai ka hōʻike koko CO2

E kauoha kāu kauka i kahi hōʻike koko CO2 e pili ana i kāu mau ʻōuli. ʻO nā hōʻailona o ke kaulike ʻole o ka oxygen a me carbon dioxide a i ʻole ke kaulike ʻole PH me:

• pokole o ka hanu
• nā pilikia hanu ʻē aʻe
• nausea
• ka luaʻi

Kuhi paha kēia mau ʻōuli i ke kīnā ʻole o ka hū e pili ana i ka hoʻololi ma waena o oxygen a me carbon dioxide.

Pono ʻoe e ana i nā oxygen o kou koko a me nā pae kalapona kalapona e ana pinepine ʻia inā ʻoe ma ka oxygen therapy a i ʻole ke loaʻa ʻana i kekahi mau ʻoki.

Pehea e lawe ʻia ai kahi laʻana koko

Hiki ke lawe ʻia i nā laʻana koko no ka hoʻāʻo ʻana koko CO2 mai kekahi aʻa a i ʻole kahi aʻa.

Laʻana koko Venipuncture

ʻO Venipuncture ka manawa i hoʻohana ʻia e wehewehe i kahi laʻana koko maʻamau i lawe ʻia mai kahi aa koko. E kauoha kāu kauka i kahi laʻana koko maʻalahi o ka venipuncture inā makemake lākou e ana iā HCO3.

E kiʻi i kahi laʻana koko venipuncture, kahi mea mālama ola:

• hoʻomaʻemaʻe i ka pūnaewele (ʻo ka manawa ma loko o ka kuʻe lima) me kahi antiseptic pepehi kanaka germ
• 'ōwili i kahi kāʻei elima a puni kou lima e hoʻoulu i ke aa koko me ke koko
• e hoʻokomo mālie i kahi nila i loko o ka aa a hōʻiliʻili i ke koko i ka paipu i hoʻopili ʻia a hiki i kona piha ʻana
• hemo i ke kāʻei paʻa a me ka nila
• uhi i ka ʻeha kuʻi me ka gauze sterile e hoʻōki i ke kahe ʻana o ke kahe

Laʻana koko arterial

ʻO ke kākāʻī kino koko kahi ʻāpana o ka hoʻāʻo CO2. Pono ke kaʻina hana kinoea i ke koko arterial ma muli o ke kinoea a me nā pae pH i nā aʻa i ʻokoʻa mai ke koko venous (ke koko mai kahi aa koko).

Hāpai nā aʻa i ka oxygen ma loko o ke kino. Hāpai nā uaua i nā ʻōpala metabolic a me nā koko deoxygenated i nā akemāmā e huki ʻia e like me carbon dioxide a i nā puʻupaʻa e hoʻoili ʻia i ka mimi.

Hana ʻia kēia hana ʻoi loa paʻakikī e kahi mea hoʻomaʻamaʻa i hoʻomaʻamaʻa ʻia e komo pono i nā aʻa. Lawe pinepine ʻia ke koko arterial mai kahi aʻa i loko o ka pulima i kapa ʻia ʻo ke aʻa radial. ʻO kēia ke aʻa nui i ka laina me ka manamana nui, kahi e hiki ai iā ʻoe ke haha ​​i kou pulse.

A i ʻole, hiki ke hōʻiliʻili ʻia ke koko mai ke aʻa brachial i ka kuʻe lima a i ʻole ke aʻa wahine i loko o ke aʻa. E kiʻi i kahi laʻana koko arterial, ka mea hana:

• hoʻomaʻemaʻe i ka pūnaewele me kahi antiseptic pepehi kanaka germ
• e hoʻokomo mālie i kahi nila i loko o ke aʻa a huki i ke koko i loko o kahi paipu paʻa a hiki i kona piha ʻana
• hemo ka nila
• pili ikaika i ka ʻeha i ka ʻeha no ʻelima mau minuke e hōʻoia i ke kū ʻana o ke kahe. (Hāpai nā aʻa i ke koko i nā kaomi kiʻekiʻe aʻe ma mua o nā veins, no laila he mea nui ka manawa no ke koko e hana i kahi ʻōpala.)
• kau i kahi wahī paʻa a puni ka pūnaewele puncture e pono ai e noho ma kahi no hoʻokahi hola

Pehea e hoʻomākaukau ai no kāu hōʻoia koko

E noi paha kāu kauka iā ʻoe e hoʻokē ʻai, a i ʻole e hōʻoki i ka ʻai ʻana a me ka inu ʻana, ma mua o ka hoʻāʻo ʻana o ke koko. E noi paha kāu kauka iā ʻoe e hōʻoki i ka lawe ʻana i kekahi mau lāʻau i mua o ka hoʻāʻo e like me corticosteroids a i ʻole antacids. Hoʻonui kēia mau lāʻau i ka paʻa o ka bicarbonate i ke kino.

Nā pilikia o kahi hōʻike koko CO2

Aia kekahi mau pōpilikia e pili pū ana me nā ʻāpana ʻelua a me nā hoʻokolohua koko arterial. Pākuʻi ʻia kēia mau mea:

• kahe nui ke koko
• maule ana
• ʻālohilohi
• hematoma, he puʻu koko ia ma lalo o ka ʻili
• maʻi ma ka puncture kahua

Ma hope o ke kahakaha ʻana o ke koko, e hōʻoia kāu mea hoʻomaʻamaʻa ke maikaʻi ʻoe a e haʻi iā ʻoe pehea e mālama ai i ka pūnaewele puncture e hoʻemi i ka manawa o ka maʻi.

Nā hopena hōʻike

ʻO ka pae maʻamau no CO2 he 23 a 29 mEq / L (milliequivalent unit per liter of blood).

Ana pinepine ke kauka koko i ke koko pH me nā pae CO2 e hoʻoholo hou i ke kumu o kāu mau hōʻailona. ʻO ke koko pH kahi ana o ka acidity a i ʻole alkalinity. ʻO Alkalosis ke alkaline o kou kino wai. ʻO ka Acidosis, ma ka ʻaoʻao ʻē aʻe, ʻoiai ke acidic loa kou kino kino.

ʻO ka maʻamau, he kumu liʻiliʻi ke koko me ke ana ʻana o ka pH ma kahi o 7.4 i mālama ʻia e ke kino. Kuhi ʻia nā pae maʻamau mai 7.35 a i 7.45 i kūlike ʻole. ʻO ke ana ʻana o ke koko ma lalo o 7.35 ka mea i manaʻo ʻia he acidic. ʻOi aku kahi alkaline o kahi mea ke ʻoi aku ke ana o ke koko ma mua o 7.45.

Low bicarbonate (HCO3)

ʻO kahi hopena hōʻike o ka bicarbonate haʻahaʻa a me ka pH haʻahaʻa (ma lalo o 7.35) kahi ʻano i kapa ʻia ka metabolic acidosis. ʻO nā kumu maʻamau:

• hakuʻala ʻole
• ʻōpū nui loa
• acidosis lactic
• ka hopu ʻana
• maʻi ʻaʻai
• lōʻihi ka nele o ka oxygen mai anemia koʻikoʻi, puʻuwai ʻole, a haʻalulu paha
• ketoacidosis diabetic (diabetic acidosis)

ʻO kahi hopena hōʻike o ka bicarbonate haʻahaʻa a me ka PH kiʻekiʻe (ʻoi aku ma mua o 7.45) kahi kūlana i kapa ʻia ʻo alkalosis respiratory. ʻO nā kumu maʻamau:

• hyperventilation
• fiva
• ʻeha
• hopohopo

High bikarbonate (HCO3)

ʻO kahi hopena hōʻike o ka bicarbonate kiʻekiʻe a me ka pH haʻahaʻa (ma lalo o 7.35) kahi ʻano i kapa ʻia ka acidosis respiratory. ʻO nā kumu maʻamau:

• pulumonia
• maʻi pulmonary pulupulu paʻa (COPD)
• hānō
• pulmonary fibrosis
• ka hōʻike ʻana i nā kemika ʻino
• nā lāʻau e kāohi i ka hanu ʻana, keu hoʻi ke hoʻohui ʻia me ka wai ʻona
• maʻi puʻu
• maʻi ʻaʻai pūpū
• pulmonary hypertension
• momona nui loa

ʻO kahi hopena hōʻike o ka bicarbonate kiʻekiʻe a me ka PH kiʻekiʻe (ʻoi aku ma mua o 7.45) kahi kūlana i kapa ʻia ʻo ka alkalosis metabolic. ʻO nā kumu maʻamau:

• luai mau
• pae pae potassium haʻahaʻa
• hypoventilation, kahi e hoʻopili ai i ka hanu ʻana a hoʻemi ʻia ka CO2 hoʻopau

Nānā wā lōʻihi

Inā loaʻa i kāu kauka kahi kaulike CO2 e hōʻike nei i ka acidosis a i ʻole alkalosis, e nānā lākou i ke kumu o kēia kaulike ʻole a mālama pono iā ia. Ma muli o ka ʻokoʻa o nā kumu, hiki i ka mālama ʻana ke hoʻopili i nā loli o ka nohona, nā lāʻau, a me nā ʻokiʻoki.