- . (. 30-6):
. 30-6. - |
1. : ?
2. PaCO2: PaCO2 ?
3. PaCO2 [HCO ] ?
4. (. 30-1).
5. [HCO3"] PaCO2: (. 30-7)? 2/[]> , , PaCO2 [~] . - - .
6. , , - .
7. , .
8. : .
, , , , CO2 HCOr. - : CO2 12 . . 0,1 . - : HCO3' 6 0,1 . , - .
PO2, PCO2, , [], (BE) SO2. , PO2, PCO2 . -, -, a SO2 SO2 . .
, - . PvO2 40 ct , . PvO2 4-6 ct PaCO2. , 0,05 . , . , . . , ( ) , , , . , , - PCO2 PO2.
|
|
PCO2 PO2 . Pa-
30-7. -
T[HCO3-] | 1 / 10 . . PaCO2 | |
T[HCO3I | 4 / 10 . . PaCO2 | |
1[HCO3-] | 2 / 10 . . PaCO2 | |
1[HCO3-] | 4 / 10 . . PaCO2 | |
JPaCO2 | 1,2 [HCO3"] | |
TPaCO2 | 0,7 [HCO3"] |
, , . PCO2 PO2, [HCO3'] . 37 0C, . "" , 37 0C. 37 0C (. 21).
, . , . , () ( ), , . / / (). -- . . , , H+.
PCO2
, PCO2. ( ) . , CO2: CO2 . PCO2 .
|
|
PO2
PO2 . -
(NaCl KCl) / . , . , , PO2. ~.
: -
1 - -. , . , , , - . ( , 20 "1, FiO2 = 1,0). , :
PaCO2 = 11 . .
- 7,47
PaO2 = 209 . .
[HCO3"] = 7,7 /
= -14,6 /
Hb = 95 /
[Na"] = 135 /
[Cl"] = 95 /
[K+] = 5,5 /
[ CO2] = 8 /
, [ CO2] [HCO3"] , CO2.
- ?
, , ( > 7,45), (PCO2 < 40 . .). PaCO2 30 . ., -
HCO3 18 /:
(40 - 10) 2 //10 = 6 / 24 /.
. (11 /) 10 / , ! , - : . , [HCO3'] .
?
, . - :
= 135 - (95 + 8) = 32 /.
14,4 /, . , .
?
, . . . . (: 140-160 /), . , . (FiO2 = 0,5) :
PaCO2 = 23 . .
= 7,52
PaO2 = 136 . .
[HCO3"] = 18 /
= -3 /
Hb-103 /
[Na4] = 137 /
[Cl"] - 92 /
[K+] = 3,9 /
[ CO2] = 18,5 /
- ?
, . , , . PaCO2 , [HCO3-] 20,6 /:
|
|
(40 - 23) 2 //10 = 3,4 /, 24 /.
[HCO3"] 2 / 20,6 /, . , [HCO3'] , :
= 137 - (92 +18) = 27.
12,2 /.
, ( ).
- : , . , , , ( ). .
, - , 24 - :
PaCO2 = 35 . .
= 7,51
PaO2 =124 . .
[3~] = 26,8 /
= +5,0 /
Hb = 150 /
[Na+] =136 /
[] = 91 /
[K+] = 3,2 /
[ CO2] = 27 /
= 2,7 /
, .
KCl 0,9 % NaCl . .
Cogan M. G. Fluid and Electrolytes: Physiology and Pathology. Appleton & Lange, 1991.
Narins R. G., Emmett M. Simple and mixed acid-base disorders: A practical approach. Medicine, 1980; 59: 161.
Rose B. D. Clinical Physiology of Acid-Base and Electrolyte Disorders, 4th ed. McGraw-Hill, 1994.
Schrier R. W. (editor). Renal and Electrolyte Disorders, 4th ed. Little, Brown, 1992.
Shapiro B. A., Kozlowski-Templin R., Peruzzi W. T. Clinical Application of Blood Gases, 5th ed. Mosby Year Book, 1993.