Respiratory acidosis

Description:

Respiratory acidosis is characterized by decrease рН blood and a hypercapnia (increase rs02 blood more than 40 mm hg). At the same time there is no linear dependence between degree of a hypercapnia and clinical signs of respiratory acidosis. The last in many respects are defined by the hypercapnia reason, features of a basic disease and reactivity of an organism of the patient.
• The compensated acidosis, as a rule, does not cause essential changes in an organism.
• Noncompensated acidosis leads to considerable disturbances of life activity of an organism and development of a complex of characteristic changes in it.

Symptoms of Respiratory acidosis:

Danger of a bronchospasm in the conditions of acidosis consists in a possibility of formation of a vicious pathogenetic circle "a bronchospasm-> increase rs02-> bystry decrease рН-> strengthening of a bronchospasm-> further increase rs02".

• Expansion of arterioles of a brain, development of an arterial hyperemia of tissue of brain, increase in intracranial pressure.
Reasons: long considerable hypercapnia and hyperpotassemia.
Mechanism: decrease in a basal muscle tone of walls of arterioles of a brain in the conditions of for a long time raised rs02, рН and hyperpotassemias.
reasons and symptoms of respiratory acidosises.
Manifestations of the increased intracranial pressure:
- at first headache and psychomotor excitement,
- then drowsiness and block.
The prelum of substance of a brain leads also to increase in activity of neurons of a vagus nerve. It, in turn, causes:
- arterial hypotension,
- bradycardia,
- sometimes cardiac standstill.

• A spasm of arterioles and ischemia of bodies (except a brain!).
Reasons
- Giperkatekholaminemiya who is observed in the conditions of acidosis.
- Gipersensitization and - adrenoceptors of peripheral arterioles.

Manifestations of a spasm of arterioles: Ischemia of fabrics and bodies is followed by multiorgan dysfunction. However symptoms of ischemia of kidneys, as a rule, dominate: at substantial increase rs02 the renal blood stream and volume of glomerular filtering decreases and the mass of the circulating blood increases. It considerably raises load of heart and at chronic respiratory acidosis (for example, at patients with respiratory insufficiency) can lead to decrease in sokratitelny function of heart, i.e. to heart failure.

Reasons of Respiratory acidosis:

Reason: the accruing hypoventilation of lungs. It is the main factor of emergence of a gaseous acidosis (at a spasm of bronchioles or obturation of respiratory tracts).

Mechanism of a spasm of bronchioles: increase in cholinergic effects in the conditions of considerable acidosis. It is result:
- The increased release of acetylcholine from nervous bombways.
- Increases in sensitivity of holinoretseptor to acetylcholine.

Treatment of Respiratory acidosis:

Only the sure method of treatment at respiratory acidosis consists in stopping of a basic disease. At a stop of activity of cardiopulmonary system bystry injection of alkaline solutions is justified. In other situations injection of alkaline solution for the purpose of stopping of respiratory acidosis is almost inefficient.