TAILIEUCHUNG - Chapter 048. Acidosis and Alkalosis (Part 13)

The clinical features vary according to the severity and duration of the respiratory acidosis, the underlying disease, and whether there is accompanying hypoxemia. A rapid increase in Pa CO2 may cause anxiety, dyspnea, confusion, psychosis, and hallucinations and may progress to coma. Lesser degrees of dysfunction in chronic hypercapnia include sleep disturbances, loss of memory, daytime somnolence, personality changes, impairment of coordination, and motor disturbances such as tremor, myoclonic jerks, and asterixis. Headaches and other signs that mimic raised intracranial pressure, such as papilledema, abnormal reflexes, and focal muscle weakness, are due to vasoconstriction secondary to loss of the. | Chapter 048. Acidosis and Alkalosis Part 13 The clinical features vary according to the severity and duration of the respiratory acidosis the underlying disease and whether there is accompanying hypoxemia. A rapid increase in PaCO2 may cause anxiety dyspnea confusion psychosis and hallucinations and may progress to coma. Lesser degrees of dysfunction in chronic hypercapnia include sleep disturbances loss of memory daytime somnolence personality changes impairment of coordination and motor disturbances such as tremor myoclonic jerks and asterixis. Headaches and other signs that mimic raised intracranial pressure such as papilledema abnormal reflexes and focal muscle weakness are due to vasoconstriction secondary to loss of the vasodilator effects of CO2. Depression of the respiratory center by a variety of drugs injury or disease can produce respiratory acidosis. This may occur acutely with general anesthetics sedatives and head trauma or chronically with sedatives alcohol intracranial tumors and the syndromes of sleep-disordered breathing including the primary alveolar and obesity-hypoventilation syndromes Chaps. 258 and 259 . Abnormalities or disease in the motor neurons neuromuscular junction and skeletal muscle can cause hypoventilation via respiratory muscle fatigue. Mechanical ventilation when not properly adjusted and supervised may result in respiratory acidosis particularly if CO2 production suddenly rises because of fever agitation sepsis or overfeeding or alveolar ventilation falls because of worsening pulmonary function. High levels of positive end-expiratory pressure in the presence of reduced cardiac output may cause hypercapnia as a result of large increases in alveolar dead space Chap. 246 . Permissive hypercapnia is being used with increasing frequency because of studies suggesting lower mortality rates than with conventional mechanical ventilation especially with severe central nervous system or heart disease. The potential beneficial effects of .

• Y học thường thức
• Acidosis and Alkalosis
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Arterial blood gas interpretation
• Metabolic alkalosis
• Compensatory mechanisms
• BMC Pharmacology and Toxicology
• Airway surface liquid pH
• Airway blood flow
• Blood gases
• Case examples
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care
• Handbook of blood gas
• Base interpretation
• Buffer systems
• Carbon dioxide levels
• Gas exchange
• The non invasive monitoring
• Clinical approach
• Diagnose acid–base disorders
• Drinking binge yesterday