全身麻醉期间急性呼吸性碱中毒时的酸碱平衡、血气变化及“乳酸过量”

Acid-base balance and blood gases changes and "lactate excess" in acute respiratory alkalosis during general anaesthesia.

作者信息

Rybicki Z, Jung M, Michajlik A, Kański A

出版信息

Anaesth Resusc Intensive Ther. 1976 Jul-Sep;4(3):167-73.

Abstract

In 40 young males aged 18-20 years operated on for inguinal hernioplasty acute respiratory alkalosis was obtained in the 45th minute of general anaesthesia. The values of basic acid-base balance parameters, blood gases, pyruvate and lactate levels and "lactate excess" were determined before and after hyperventilation. Shifts in the concentrations of hydrogen and bicarbonate ions were found which are both typical of acute respiratory alkalosis. No changes were observed in the oxygenation of capillary blood and the values of "lactate excess" were normal which rules out tissue hypoxia during acute respiratory alkalosis. Passive hyperventilation being a less dangerous alternative of hypoventilation is a frequent occurrence during general anaesthesia and it causes transient respiratory alkalosis.

摘要

在40名年龄在18至20岁接受腹股沟疝修补术的年轻男性中，全身麻醉第45分钟时出现急性呼吸性碱中毒。在过度通气前后测定了基本酸碱平衡参数、血气、丙酮酸和乳酸水平以及“乳酸过量”值。发现了氢离子和碳酸氢根离子浓度的变化，这两者都是急性呼吸性碱中毒的典型表现。未观察到毛细血管血液氧合的变化，“乳酸过量”值正常，这排除了急性呼吸性碱中毒期间的组织缺氧。被动过度通气作为低通气的一种危险性较小的替代方式，在全身麻醉期间经常发生，它会导致短暂的呼吸性碱中毒。