Metabolic disorders



alkalosis photo alkalosis - a kind of imbalance balance of acids and bases, which is characterized by a total or partial overabundance of hydrogen Join substances than their cleaves acids.Depending on the numbers of blood pH, the disease can be compensated or decompensated.If compensated alkalosis, the pH value ranges of normal for the human values ​​(from 7.35 to 7.45), some changes that may be in violation of buffers and physiological mechanisms of regulation.Uncompensated alkalosis is accompanied by a high pH value - more than 7.45.The reason for this is a serious reason to oversupply and poor regulation of the balance of acids, alkalis.

alkalosis and acidosis

Acidosis - an imbalance in the body, accompanied by the excessive amount of acid in the blood.Alkalosis - a large number of reasons.Acidosis and alkalosis compensated - a condition of the body, in which the absolute change of H2CO3, NaHCO3, but despite this, their relationship is stored in the normal (one in twenty).If the ratio men

tioned above is stored, pH varies within the normal range.

failures in the regulation of CBS occur in some extreme conditions for the organism under certain diseases.The buffers of the blood system, excretory, respiratory systems can not cope with the system maintaining the required level of pH.Because of this, there is an accumulation of blood or acids or bases, which leads to acidosis or alkalosis.

Both of equilibrium changes divided into species that are allocated depending on whether the change of water which caused the indicator.One of the reasons - changes in the system of ventilation.Thus, increased ventilation (hyperventilation) will reduce the tension CO2.Large carbon dioxide tension of blood often occurs when different lung diseases.Changes in the normal balance of acids and bases, which was the cause of dysfunction in the system of ventilation of the lungs, called respiratory alkalosis (acidosis).When problems with metabolism (eg, diabetes), accumulate in the bloodstream non-volatile acid.With the loss of the body HCl (vomiting), the reverse process - a decrease in the concentration of non-volatile acids.These changes are known as metabolic acidosis, alkalosis.

non-respiratory acidosis, alkalosis occur due to non-disordered breathing changes (eg, kidney disease).The difference between a non-respiratory acidosis and respiratory alkalosis, and can be the ratio of the voltage level of PCO2 and buffer bases.The starting point is considered to be the level of concentration of buffer bases equal to forty-eight millimoles per liter.This conditional zero.If the level is significantly different from the reference numerals, this is called kurtosis bases.If the deviation from the norm was to decrease, it is called a reduction (deficit).

for respiratory disorders characterized by change causes PCO2 to decrease or, conversely, increase, without changes in the level of buffer bases.When non-respiratory disorders decrease or increase in PCO2 preceded base excess.And acidosis and alkalosis are divided into types.Types of alkalosis: excretory, exchange, breathing, non-gas, gas alkalosis.

Metabolic alkalosis

Metabolic alkalosis reflected in a reduction in the extracellular space of hydrogen, chlorine.He is characterized by large numbers of pH and bicarbonate concentration.In severe cases of metabolic alkalosis makes itself felt intense headaches, tetany, lethargy.In this case, you need to work on the original reasons that led to alkalosis.Sometimes the patient has entered HCl or Acetazolamide.

main factors of occurrence of metabolic alkalosis - loss of positively charged hydrogen organism load bicarbonate.Loss of H +, accompanied by such kind of acidosis is often found in patients with abnormal renal, gastrointestinal tract.In this case, hydrogen ions leave the organism with chlorine.Hloridchuvstvitelny alkalosis often occurs due to vomiting (multiple), when draining the stomach, diuretic therapy drugs.Hloridrezistentny alkalosis accompanied by Conn's syndrome, Cushing's, adrenal, Bartter syndrome, when the potassium starvation.It occurs also in renovascular hypertension, the therapy with glucocorticoids.

Metabolic alkalosis is sometimes accompanied by blood transfusion in large volumes, bicarbonate treatment.With such a person loses potassium alkalosis that may lead to DOS and increased sensitivity of the heart to certain drugs (most often to cardiac glycosides).In this state, the output calcium.This entails increased neuromuscular excitability, development of seizures.Terrible complication is failure of enzyme systems.

Respiratory alkalosis

This kind of alkalosis is caused by chronic or acute hyperventilation, which is why the pressure of CO2 is significantly reduced.It is divided into acute and chronic.

Chronic respiratory alkalosis occurs when a person has long been a moderate hypercapnia.Alkalosis, is acute, occurs when a pronounced hypercapnia.

When respiratory alkalosis blood begins to flow to the brain in lower volumes due to the rapid decrease in PCO2.This can cause lightheadedness, seizures, stupor state.If patients have heart disease due to the recoil of oxygen may reduce arrhythmia appear.Causes respiratory alkalosis K, Na +, and migrate through the membrane phosphates, Ca2 + binds to the cells and decreases in protein concentration.Because there is a small hypocapnia hypokalemia.

Respiratory alkalosis is very often the case with lying critically ill patients.Alkalosis in the weak manifestation can often be seen in the early stages of diseases cardiovascular system, respiratory system, and hyperventilating when combined with a normal pressure of CO 2 and hypoxemia, it indicates the beginning of decompensation.In this case, an urgent need to examine the patient and prescribe treatment.

Often this type alkalosis develops when the ventilator.It can lead to long-term effects, since the numbness of the lips, the occurrence of paresthesia, nausea, feeling of chest compression are long and occasionally appear.To counter hyperventilation may cause any damage to the nervous system.

alkalosis - a symptom of poisoning stimulates the central chemoreceptors salicylates.Taking certain funds strengthens the respiratory center response and ventilation.They are Aminophylline and theophylline (a methylxanthine group).Pregnant at times increased serum progesterone, which causes hyperventilation and alkalosis are not life-threatening.When liver failure respiratory alkalosis blood - not uncommon.And, the brighter it is, the more serious liver pathology.Respiratory alkalosis may be the first start-up of sepsis, as it develops before a detailed picture of the disease (fever, hypotension, hypoxemia).

alkalosis causes

alkalosis Each type has its own reasons for the appearance.Thus, metabolic alkalosis occurs due to the massive loss of hydrogen ions by the body.The reason for the loss of the necessary vital ions can serve as repeated vomiting, which lost a lot of hydrochloric acid from the stomach, treatment with drugs that significantly increase diuresis, drains into the stomach, prolonged use of corticosteroids or drugs that are bright mineralocorticoid properties.

special place occupied syndromes and metabolic diseases (C m Cushing, Barter, Conn, congenital adrenal hyperplasia).The massive infusion of blood components and substitutes can also trigger the disease.This condition is extremely rare, but it can backfire.Most often it is found in the postoperative period after major operations, as well as in young children with rickets.

Exogenous alkalosis occurs in patients who were given very high dose of sodium bicarbonate (it is administered at high acidity in the stomach).This usually occurs by accident or a serious long-term treatment doses.In rare cases, this type of possible alkalosis due to prolonged food products with a high content of bases in its structure (the same type food, meager diet).

Decompensated metabolic alkalosis often occurs because of the nature of the loss of the body of chlorine (primary or secondary).Increased ambient temperature, accompanied by a lack of water in the body can also lead to alkalosis.This increases the unbearable thirst, severe fatigue at the most usual loads and weakness, causing a desire to lie down.Starts alarming headache, hyperkinesias occur in small muscles (usually the face, hands), appetite deteriorates.

Mixed alkalosis - a non-gas alkalosis, combined with gas.He appears in the brain injury, in which the developing dyspnea, hypercapnia, vomiting sour.In this pathological condition in humans pressure drops and reduced heart rate, increases neuromuscular stimulation, there is hypertonicity, which leads to seizures.Quite often alkalosis accompanied by constipation and worsening of respiratory activity.Diagnose also common symptoms: worsening health, permanent weakness, reluctance to do anything, dizziness until obscuring or even a loss of consciousness.

alkalosis symptoms

Symptoms gas form alkalosis is in violation, which are caused by hypocapnia.These include high pressure cerebral arteries, veins hypotension at the periphery of the pressure drop and cardiac output, loss in the urine cations.

very first significant signs of alkalosis phenomena are diffuse brain ischemia.Because of this, the patient is anxious, nervous, dizzy, there are paresthesias of extremities, face, he quickly tired of communication, impaired memory and attention.

skin in this state has a pale color, gray cyanosis may occur due to hypoxemia.During the inspection, you can easily find the cause of alkalosis - breath of forty to sixty cycles per minute.This may be accompanied by breathing thromboembolism LA hysterical shortness of breath, when the ventilator for more than ten liters per minute, in other pathologies.Often such alkalosis accompanied by tachycardia, low heart rate, rhythm tones pendulum.When the patient lies, blood pressure drops significantly, and the transition to an upright condition often develops orthostatic collapse.Growing diuresis, when protracted alkalosis increases the risk of dehydration.Hypocalcemia develops that causes the development of seizures.

If the patient has in the past organic lesion or epileptic readiness of the National Assembly of the brain increased, physicians should be prepared for what may suddenly start an epileptic fit.On EEG basic rhythm fluctuations raised, and the frequency is reduced, diagnosed bilateral synchronous discharges of slow waves.On electrocardiography - extensive changes in the repolarization of the heart muscle.Sometimes the cause of a gas alkalosis may be a chronic course of hepatitis.The pathophysiology of this phenomenon is not yet clear.Such alkalosis totally uncharacteristic of any clinic.In this case, display only those that are related to the underlying disease (hepatitis).

Metabolic alkalosis in the majority of reported cases is compensated in nature, it has no bright signs and symptoms.Sometimes this is accompanied by swelling or alkalosis pastoznost, signs of respiratory depression.Decompensated alkalosis happens after vomiting, often repeated, when the body hemolysis occurs with loss of potassium chloride.It often occurs during a terminal condition which accompanies dehydration.

decompensated alkalosis makes itself felt weakness, thirst, small hyperkinesia, lack of appetite, headaches, constant desire to drink fluids.The skin is dry with a significantly reduced turgor.If there is no heart failure, pneumonia, breathing is superficial, it is rare.Tachycardia - a characteristic feature of this type of alkalosis.In the early stages, patients apathetic, and later there is some confusion in the mind, a strong sleepy.If you do not have to help these stages can occur up to the worsening state of coma.ECG helps ensure hypokalemia, T-wave voltage is very low.Blood analysis indicates low levels of calcium, potassium, chlorine plasma.The reaction of the urine alkaline (in the case of alkalosis with primary loss of potassium - sour).

Bernet syndrome (milk-alkali with th) - chronic metabolic alkalosis.The disease often occurs in people with stomach ulcers, which should always take into alkaline means milk.Alkalosis reflected in the fact that a growing aversion to dairy products, reduces appetite, increases apathy weakness, skin begins to itch.Often in the conjunctiva, cornea, kidney tubules appear accumulation of salts (calcium).This may cause renal failure.

Metabolic alkalosis - satellite Barter syndrome.Pathology is a congenital disorder of movement of chlorine in the renal tubules.The disease manifests in the first months of life, begins with vomiting, developmental delay.Later diagnosed polyuria and polydipsia.In the blood - hypochloremia, renin activity and the amount of aldosterone increased, hypokalemia.

alkalosis in children

alkalosis in children develops the same principles as in adults, but because of the fact that the metabolism of the child more labile, it is more common in many pathological conditions.

Toddlers alkalosis metabolic type is often, if the child has suffered from a birth trauma, he has pyloric stenosis, impaired patency of the intestine.

Permanent alkalosis childhood can be observed in certain diseases transmitted by inheritance to the kid.Certain inherited diseases accompanied by poor transport of chlorine in the gastrointestinal tract.In this case, the child makes a stool, which is determined by a lot of chlorine.The urine thus not be chlorine.

toxic syndrome in a child entails a state of hyperventilation, which leads to alkalosis gas species.Such a condition can occur during respiratory diseases viral origin, meningitis, pneumonia, fever, cranial trauma, brain tumors, encephalitis.

artificial lung ventilation during resuscitation or surgical procedures can provide the impetus for the emergence of a child compensated type gas alkalosis.Such a state of transient.The disease can also be marked, for example, in cases of poisoning nature sulfa drugs or salicylates.That is why it is necessary to hide all medications away from children.

If alkalosis appears an acute shortage of calcium, the child will have to shake the limbs, seizures occur periodically, it will start to sweat.Older children will complain that the noise in the ears, hands numb and tingling.If violations have gone deep, can appear and violations of neuro-psychological nature.Such changes are in children under which developed acute hypercapnia.

alkalosis treatment

and metabolic and gas, and the mixed alkalosis developed against severe disease requires immediate hospitalization.

If the reason lies in the gas alkalosis hyperventilation neurogenic (nervous shock, hysterical), assistance may be provided on the spot, without defining in a hospital.In this case, it is necessary to protect the person from the traumatic factor, soothe and create all favorable conditions for calm.It is necessary to give sedatives (suit a couple of tablets of valerian), if the patient feels that his heart is beating strongly feel dizzy after the shock, it is necessary to Validol or Corvalol (Corvalol - not more than fifteen drops, Validol - tablet under the tongue).These drugs have almost every medicine cabinet, in which case they will be effective, will help to calm down, recover and normalize the rhythm of the heart and improve as a whole.

Then, if necessary, you can move on to the activities that will prevent itself alkalosis.

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