Acidosis

Acidosis mamiriro umo mune acid yakawandisa mumuviri wemvura. Icho chakapesana nealkalosis (mamiriro umo mune hwaro hwakawandisa mumuviri wemvura).

Itsvo nemapapu zvinochengetedza zviyero (zvakakodzera pH nhanho) yemakemikari anonzi acids uye zvigadziko mumuviri. Acidosis inoitika apo asidhi inovaka kana kana bicarbonate (hwaro) yarasika. Acidosis inorondedzerwa senge yekufema kana metabolic acidosis.

Respiratory acidosis inokura kana paine yakawanda carbon dioxide (acid) mumuviri. Mhando iyi yeacidosis inowanzo kukonzerwa kana muviri usingakwanise kubvisa kabhoni dhayokisaidhi yakawandisa kuburikidza nekufema. Mamwe mazita ekufema acidosis anonzi hypercapnic acidosis uye carbon dioxide acidosis. Zvinokonzera kufema acidosis zvinosanganisira:

• Chifuva chakaremara, senge kyphosis
• Kukuvara kwechifuva
• Chest mhasuru kushaya simba
• Yenguva refu (isingaperi) chirwere chemapapu
• Neuromuscular kusagadzikana, senge myasthenia gravis, muscular dystrophy
  
• Kunyanyisa kushandisa zvinodhaka

Metabolic acidosis inokura kana iine acid yakawanda inogadzirwa mumuviri. Izvo zvinogona zvakare kuitika kana itsvo dzisingakwanise kubvisa yakaringana acid kubva mumuviri. Kune akatiwandei mhando ye metabolic acidosis:

• Diabetic acidosis (inonziwo chirwere cheshuga ketoacidosis uye DKA) inokura apo zvinhu zvinonzi ketone miviri (iri acidic) inovakwa panguva yechirwere cheshuga chisina kudzorwa.
• Hyperchloremic acidosis inokonzerwa nekurasikirwa nesodium bicarbonate yakawandisa kubva mumuviri, izvo zvinogona kuitika nemanyoka akakomba.
• Itsvo chirwere (uremia, distal renal tubular acidosis kana proximal renal tubular acidosis).
• Lactic acidosis.
• Chepfu neasprini, ethylene glycol (inowanikwa muantifreeze), kana methanol.
• Kunyanya kupera mvura mumuviri.

Lactic acidosis inovaka lactic acid. Lactic acid inonyanya kugadzirwa mumaseru maseru uye masero matsvuku eropa. Iyo inoumba kana muviri uchipaza makabhohaidhiretsi kuti ushandise simba kana iwo oxygen mazinga akaderera. Izvi zvinogona kukonzerwa ne:

• Gomarara
• Kunwa doro rakawandisa
• Kudzidzira zvine simba kwenguva yakareba kwazvo
• Chiropa kutadza
• Shuga shoma yeropa (hypoglycemia)
• Mishonga, senge salicylates, metformin, anti-retrovirals
• MELAS (yakajairika geni mitochondrial kusagadzikana kunokanganisa kugadzirwa kwesimba)
• Kushaikwa kwenguva refu kweoksijeni kubva mukuvhunduka, kushaya moyo, kana kushaya simba kwakanyanya
• Kufenda
• Sepsis - chirwere chakakomba nekuda kwehutachiona hwehutachiona kana zvimwe hutachiona
• Carbon monoxide chepfu
• Asthma yakaoma

Metabolic acidosis zviratidzo zvinoenderana nechakakonzera chirwere kana mamiriro. Metabolic acidosis pachayo inokonzeresa kufema nekukurumidza. Kuvhiringidzika kana kuneta kunogona kuitika. Yakakomba metabolic acidosis inogona kutungamira mukuvhunduka kana kufa.

Kufuridzira acidosis zviratidzo zvinogona kusanganisira:

• Kuvhiringidzika
• Kuneta
• Lethargy
• Kufema kwekufema
• Kurara

Anopa hutano anozoongorora muviri uye obvunza nezve zviratidzo zvako.

Rabhoritari bvunzo dzinogona kurairwa dzinosanganisira:

• Arterial ropa gasi kuongorora
• Basic metabolic pani (boka reropa rinoyera iro rinoyera sodium uye potasiamu mazinga, itsvo mashandiro, uye mamwe makemikari nemabasa) kuratidza kuti mhando yeacicosis is metabolic kana kufema
• Maketoni eropa
• Lactic acid bvunzo
• Weti ketoni
• Weti pH

Mimwe bvunzo inogona kudikanwa kuti uone chikonzero cheiyo acidosis inosanganisira:

• Chest x-ray
• CT mudumbu
• Kuongorora urinal
• Weti pH

Kurapa kunoenderana nechikonzero. Wako mupi achakutaurira zvimwe.

Acidosis inogona kuva nengozi kana ikasarapwa. Zviitiko zvakawanda zvinopindura zvakanaka pakurapwa.

Matambudziko anoenderana nerudzi rweiyo acidosis.

Dzese mhando dzeacidosis dzinokonzeresa zviratidzo zvinoda kurapwa nemupi wako.

Kudzivirira kunoenderana nechikonzero cheacidosis. Zvakawanda zvinokonzera metabolic acidosis zvinogona kudzivirirwa, kusanganisira chirwere cheshuga ketoacidosis uye zvimwe zvinokonzera lactic acidosis. Kazhinji, vanhu vane itsvo zvine hutano nemapapu havana chakakomba acidosis.

• Itsvo

Effros RM, Swenson ER. Acid-base chiyero. Mune: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray naNadel Chinyorwa cheKufema Kwemishonga. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits.

Ah MS, Briefel G. Kuongororwa kweiyo renal basa, mvura, electrolyte, uye acid-base chiyero. Mune: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis uye Management nemaLabhoritari Maitiro. 23rd ed. St Louis, MO: Elsevier; 2017: chitsiko 14.

Seifter JL. Acid-base kusagadzikana. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 110.