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8/17/2019 ECHILIBRUL ACIDO-BAZIC 2015.ppt
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ECHILIBRUL ACIDO-BAZIC
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MECANISMELE COMPENSATORII
• M#$'"1m 6"."#&-#"m"#
• M#$'"1m !"&*&g"#
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Fig.1.Revendicarea bicarbonatului
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Fig.2. Regenerarea bicarbonatului
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Tabel 1. Clasificarea tulburărilor acido-bazice
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• Răspunsul compensator „de aşteptat” înacdo!a respratore croncă +/,
∆ (CO)* $ -&0 ' PCO#
• Răspunsul compensator „de aşteptat” în
alcalo!a respratore acută +*,∆ (CO)* $ -- ' PCO#
• Răspunsul compensator „de aşteptat” înalcalo!a respratore croncă +*,
(CO)* $ -&1- ' PCO#
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#&%1p&'0'(
• pH 792, pCO2 5mmHg, !"#$%! 9:mEq/L
• pH 73, pCO2 3mmHg, !"#$%! 94mEq/L
• pH 732, pCO2 :mmHg, !"#$%! 39mEq/L• pH 738, pCO2 94mmHg, !"#$%! 8mEq/L
• pH 748, pCO2 2mmHg, !"#$%! 94mEq/L
• pH 752, pCO2 4;mmHg, !"#$%! 3;mEq/L• pH 752, pCO2 25mmHg, !"#$%! 2mEq/L
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C$.)%" #*"'"#
• B$%!$(, 58 $'" #) BPOC
• B$%!$(, 32 $'", #) 1('&.$ p"*&%"#$ p )*#%
pp("#, #) $#)$% "'#&mp*($ g$1("#$
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C$. 9
U' !%!$( ' >%1( 0 48 $'", 6)m(&%#%&'"# )' p$#( 0 ?"g%" p .", m$" m)*(0 2 $'"+, $6!%"*, ()"(&% #%&'"#, #)0"$m(%)* (&%$#"# $'(%&-p&1(%"&% m$% $%$*&%"*@
p( PaCO# (CO)* Na 2 Cl 3AP
7,32 : 39 937 4,8 ;3 93
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C$. 2
O 6m" ' >%1( 0 2 $'" "' *$ m0"##) m$'"61(%" 0 1p$1m&6"*", "m0"$( 0)p)' p"1&0 $#)( 0 $'"($(
p( PaCO# (CO)* Na 2 Cl 3AP
7,5: 24 29 938 3,4 92 95
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C$. 3
O 6m" ' >%1( 0 52 $'", "p%('1" '(%$($m'( #%&'"# #) "0%*&%&("$."0, )&%01"0%$($( $% $*&%"*@
p( PaCO# (CO)* Na 2 Cl 3AP
7,5 47 35 932 2,7 8 95
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C$. 4
U' !%!$( ' >%1( 0 4 $'", #) 0"$%1% 0 & 1p(m>' 1( "p&('1" "($"#$%0"#
p( PaCO# (CO)* Na 2 Cl 3AP
7,28 28 93 934 2,: 9; 92
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C$. 5
U' !%!$( ' >%1( 0 5: $'", #)'&1#)( #)BPOC, 6$# "'6$%#( m"$%0"# $#)(p%"&p%$(&% A 8/5 mmHg, (%$'1p"%$?""%#"+
p( PaCO# (CO)*
7,9 7 29
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DIEA
• P%1#%"%$ )'" 0"( '&%m$*&%"#,"p$*&%"#
•P%1#%"%$ )'" 0"( *$ )' 0"$!("#• P%1#%"%$ 0"(" p$%'(%$*
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I'0"# g*"#m"#
• A*"m'( #) "'0"# g*"#m"# 6&$%( m$%, p1(9@#&%')%", g*)#&.$, m$*(&.$, &%., p%$"()%" #) &%.,p$"' $*!$
• A*"m'( #) "'0"# g*"#m"# m$%, 8-9@B$'$', &%.!%)', m&%#&", p&%)m!, m$'g&, m)1*", #$%(&6", 1(%)g)%",p$"' "'(g%$*$
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I'0"#* g*"#m"#
• A*"m'( #) "'0"# g*"#m"# m&0%$( 5-8+@6$1&* !&$!, p&%($*, m$.$%, #$%(&6"#%$'(", p$"' '$g%$ 0 1#$%$, p$1( 6$"'&$1
• A*"m'( #) "'0"# g*"#m"# m"# 3-5+@m%,p%, "$)%(, *$p(, p"%1"#"
• A*"m'( #) "'0"# g*"#m"# 6&$%( m"# 1)! 3+
• U'(, !%$'.$, &)$, p1(, 6%)#(&.$, g%p6%)(,#$%', *g)m %.", $*)', p%)', 1&"$
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B$*$'($ N *$ p$#"'()* 0"' AI
• 2L )%"'$ "' 24 &%, #) #&'# 0 95mm&*/L )%
• 3 mm&* )%=:mm&* $.&(
• ,: m&*" $.&( =8,4 g $.&(
• U%$ %p%."'($ 8 0"' N )%"'$%@ 9,5 g (&($*N )%"'$%
• 2g 0 $.&( 1 *"m"'$ p%"' (%$'1p"%$(" 1" 1#$)'-
92,5 g 1 p"%0• 9g N 1( #"$*'( #) :25 g p%&("', 0#"
92,5 g $.&(=78g p%&("'
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N#1$%)* 0 /L/P "' $*"m'($("$p$%'(%$*$
• 95g $.&(/."=;4g p%&("'
•
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EILI
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A'$*". 0 *$!&%$(&%
• M$#%"(&.$ MCF G8
• H"p%)%"#m"
• #%1#)($• "p%-m"
• I.&6&%m $* (%$'16%"'"
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E6#( (&"# $*#&&*
• -6#( (&"# p m!%
• -$*0"0$ 1( (&"#$ p ADN 1" p%&("'
• I'"!$ g*)#&'&g'.$, !($ &"0$%$$#"."*&% g%$1", "'"!$ C
• C%1# '&*"p&g'.$+
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E6#( !'6"# $*#&&*
• C%1( HDL
•
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NALD
• NAL+
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INCIDENA NALD
• 2 "' p&p g'%$*$
• :-8 0"'(% 0"$!("#"
• NA
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PAOIZIOLOIE
•
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DN DE EJCLUDERE
• E#*)." p$("(* "%$* 1" $*#&&*"#
• E#*)." 6"!%&.$ #"1("#$ 1"
Dg' #&g%$6"# 1" (1( !"&*&g"#
-(%$'1$m"'$.
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%$($m'(
•