The present work discusses an electrolyte misbalance, caused by various changes in the acid-base state. During the study, the electrolyte balance is altered, when the compensatory mechanisms of a person are disturbed. Its timely detection and studies show that it will allow timely treatment of pH recovery.
The activity of enzymes in the blood, the separation of syntheses of the protein, carbohydrate and lipid synthesis, the sensitivity of cell receptors to hormones and mediators, the conductivity of cell membranes and intercellular structures and the physicochemical properties of colloidal systems and cell-relative compositions, etc., all depends on its ratio of hydrogen ions and ion concentrationO// . Even the acid-base balance with only minor fluctuations will affect the activity of enzymes in the blood and, therefore, there will be changes in the rate of biochemical processes, and this effect will affect the normal state of the body. The study of the acid-base state of the body is widely used to monitor the condition of heavy patients. If the blood pH is above 7.8 or below 6.8, then it does not correspond to the conditions of a person's life, which leads to death. The distribution of ions in the body depends on the degree of pH in the blood, and a change in pH can lead to changes in the concentration of ions, which affects the functioning of various systems in the body and requires proper monitoring.
The main cause of metabolic acidosis is a decrease in the release of hydrogen ions. There are 2 main types of metabolic acidosis: 1) the acidity of HCl, which is part of the blood, thereby increasing the concentration of HCO3 and the ions Cl(НС1 + НСО3>Н2СО3+С1-) increase. 2) In this case, sulfur dioxide is introduced into the bloodstream and reduces the HCO3 concentration without increasing the chlorine level.
This is the usual basic advantage of BE, which is higher than usual, which leads to an increase in pH in the blood. In this case, the intake of diuretic drugs, sodium imposes on the decrease of fluid outside the cell, potassium and chlorine. As a result, bicarbonate in the blood increases and leads to the development of alkalosis.
Objective: to determine changes in electrolytes in the blood of children of different ages in the intensive care unit due to an acid-base balance disorder.
Content and methods. Changes in the acid-base state and his medical practice are accompanied by an average range of basic parameters: pH, pCO2, the standard plasma bicarbonate SB (Standart Bicarbonate), buffer bases of capillary blood BB (Base Buffer) and capillary bleeding bases BE (Base Exess).
Taking into account the correctness of this indicator in various areas of the body, as well as to discuss this, the simplicity of blood collection, the main indicators of the acid-base state are examined in blood plasma.
(Additionally)
Additional blood parameters (ketone bodies KB, lactic acid LA) and urine (titrated acid TA and ammonia) are used to determine the cause of the degradation of gaseous forms of the acid-base state.
The numerical value of these indices can be found in Table 1. Studies to identify changes in electrolytes due to changes in acidity and alkaline balance of children in the intensive care unit. This study was conducted for children aged 9 months and 17 years who are in the intensive care unit of the Almaty hospital. Blood samples taken from heparin were used as research material.
The study was conducted in compliance with the research period. Blood tests were performed at 12 a.m.
To obtain the results of the study, an automated ABL 800 FLEX radiometer gas analyzer from “Medical” company was used. This analyzer works by determining the indexes of pH, K+, Cl~ based on the electrode method.
Results and discussion:
The results of the study are shown in table 2.
Table 1 Indicators that should be normal in the body
Model |
Sense of SI system |
Traditional unions |
Bases |
||
pH in blood: |
7,37 7,45 |
|
arterial vein capillary |
|
- |
pCO2 |
4,3 6,0 кПа |
33 46 mmHg.art. |
Bio carbonate of the blood plasma's standard (SB) |
22 26 mmol/l |
- |
Buffer bases of capillary blood (ВВ) |
44 53 mmol/l |
- |
Blood actions' bases of capillary (ВЕ) |
3,4 ± 2,5 mmol/l |
- |
Additional |
||
KD of the blood |
- |
0,5 2,5 mg% |
SK of the blood |
- |
6 -16 mg% |
TB time urine |
20 40 mmol/l |
- |
Time urine (NHt) |
10 107 mmol/l (20 50 mmol/l) |
- |
The indexes of the acid basic balance |
Middle norm |
1-group (alkaloz) |
2-group (atzidoz) |
Controlling group |
|||||
(а) 4±1,2 Age |
(б) 8±0,8 Age |
(в) 15±2 Age |
(а) 4±1,2 Age |
(б) 8±0,8 Age |
(в) 15±2 Age |
(а) 4±1,2 Age |
(б) 8±0,8 Age |
||
рн |
From 7,26 |
7,42±0,04 |
7,42±0,0 |
7,48±0,0 |
7,08±0,0 |
7,2±0,0 |
7,23±0,0 |
7,3±0,0 |
7,32±0,0 |
till 7,36 |
<0,05 |
1 <0,05 |
1 <0,05 |
3 <0,05 |
2 <0,05 |
2 <0,05 |
1 |
1 |
|
к+, mmol/l |
From 3,5 till 5,0 |
3,0±0,4 <0,01 |
3,1±0,2 <0,01 |
3,2±0,4 <0,01 |
3,8±0,4 <0,01 |
3,7±0,3 <0,01 |
4,19±0,3 <0,01 |
3,7±0,2 |
4,0±0,3 |
Cl-, |
From 97 till |
104±0,2 |
103±0,1 |
104±0,1 |
119,04± |
110±0,4 |
109±0,2 |
111±0, |
110±0,2 |
mmol/l |
115 |
<0,05 |
<0,05 |
<0,05 |
<0,01 |
<0,05 |
<0,05 |
1 |
Table 2 The indexes
the different acid-alkaline balance
pH. potassium, chlorine index
Figure 1 Chlorine's indexes, pH, Potassium Middle norm, 1 group, 2 group, controlling group
As a result of the study, it was found that the pH values of patients in the control group and blood electrolytes have an average rate in table 2 when tested.
The pH of venous blood in patients with alkaline conditions was about 1.5 times higher than in the control group. Potassium levels were lower in all 3 groups. Potassium index in the first group is 1.3 times more than in the control group.
In patients with acidosis of the 2nd group, the pH is lower than the average values of the 2nd table, and lower than in the other two groups. The potassium index is slightly different from the control group index, so we considered it the same. (a) The chlorine content in the substrate is 1.5 times higher than in the control group.
Conclusion: the lack of potassium in the body increases alkalosis, the lack of potassium in the body is due to the lack of hydrogen ions in alkalosis, which means that potassium ions are replaced by missing hydrogen protons, therefore potassium ions are absent in the body organs.
Chlorine regulates the action of cations in fluids outside the cell.
REFERENCES
- Litvitsky P.F. Pathophysiology. T.1. M.: GEOTAR-Media, 2006. P.405-448.
- Malyshev V.D. Acid-baseline state and water-electrolyte balance in intensive care: study guide. M.: OAO Publishing house "Medicine", 2005. 228 p.
- Malyshev V.D. Intensive therapy of acute water-electrolyte for doctors. M.: Medicine, 2001. 704 p.
- Malyshev Century D. Acid-baseline state and water-electrolyte balance in intensive care: Tutorial. M.: 2005. 228 p.