TAILIEUCHUNG - Chapter 048. Acidosis and Alkalosis (Part 7)

Alcoholic Ketoacidosis: Treatment Extracellular fluid deficits almost always accompany AKA and should be repleted by IV administration of saline and glucose (5% dextrose in NaCl). Hypophosphatemia, hypokalemia, and hypomagnesemia may coexist and should be corrected. Hypophosphatemia usually emerges 12–24 h after admission, may be exacerbated by glucose infusion, and, if severe, may induce rhabdomyolysis. Upper gastrointestinal hemorrhage, pancreatitis, and pneumonia may accompany this disorder. Drug- and Toxin-Induced Acidosis Salicylates (See also Chap. e34) Salicylate intoxication in adults usually causes respiratory alkalosis or a mixture of high-AG metabolic acidosis and respiratory alkalosis. Only a portion of the AG is due to salicylates. Lactic. | Chapter 048. Acidosis and Alkalosis Part 7 Alcoholic Ketoacidosis Treatment Extracellular fluid deficits almost always accompany AKA and should be repleted by IV administration of saline and glucose 5 dextrose in NaCl . Hypophosphatemia hypokalemia and hypomagnesemia may coexist and should be corrected. Hypophosphatemia usually emerges 12-24 h after admission may be exacerbated by glucose infusion and if severe may induce rhabdomyolysis. Upper gastrointestinal hemorrhage pancreatitis and pneumonia may accompany this disorder. Drug- and Toxin-Induced Acidosis Salicylates See also Chap. e34 Salicylate intoxication in adults usually causes respiratory alkalosis or a mixture of high-AG metabolic acidosis and respiratory alkalosis. Only a portion of the AG is due to salicylates. Lactic acid production is also often increased. Induced Acidosis Treatment Vigorous gastric lavage with isotonic saline not NaHCO3 should be initiated immediately followed by administration of activated charcoal per NG tube. In the acidotic patient to facilitate removal of salicylate intravenous NaHCO3 is administered in amounts adequate to alkalinize the urine and to maintain urine output urine pH . While this form of therapy is straightforward in acidotic patients a coexisting respiratory alkalosis may make this approach hazardous. Alkalemic patients should not receive NaHCO3-. Acetazolamide may be administered in the face of alkalemia when an alkaline diuresis cannot be achieved or to ameliorate volume overload associated with NaHCO3- administration but this drug can cause systemic metabolic acidosis if HCO3- is not replaced. Hypokalemia should be anticipated with an alkaline diuresis and should be treated promptly and aggressively. Glucose-containing fluids should be administered because of the danger of hypoglycemia. Excessive insensible fluid losses may cause severe volume depletion and hypernatremia. If renal failure prevents rapid clearance of salicylate hemodialysis can be .

• 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