Kellum J A
University of Pittsburgh Medical Center, Division of Critical Care, Pittsburgh, Pennsylvania 15213-2582, USA.
Crit Care. 2000;4(1):6-14. doi: 10.1186/cc644. Epub 2000 Jan 24.
An advanced understanding of acid-base physiology is as central to the practice of critical care medicine, as are an understanding of cardiac and pulmonary physiology. Intensivists spend much of their time managing problems related to fluids, electrolytes, and blood pH. Recent advances in the understanding of acid-base physiology have occurred as the result of the application of basic physical-chemical principles of aqueous solutions to blood plasma. This analysis has revealed three independent variables that regulate pH in blood plasma. These variables are carbon dioxide, relative electrolyte concentrations, and total weak acid concentrations. All changes in blood pH, in health and in disease, occur through changes in these three variables. Clinical implications for these findings are also discussed.
对酸碱生理学的深入理解对于重症监护医学的实践至关重要，就如同对心脏和肺生理学的理解一样。重症监护医生花费大量时间处理与液体、电解质和血液pH值相关的问题。由于将水溶液的基本物理化学原理应用于血浆，在酸碱生理学的理解方面取得了最新进展。该分析揭示了调节血浆pH值的三个独立变量。这些变量是二氧化碳、相对电解质浓度和总弱酸浓度。无论在健康还是疾病状态下，血液pH值的所有变化都是通过这三个变量的改变而发生的。本文还讨论了这些发现的临床意义。
