Kuwahara T, Kawai C
Saiseikai-Nakatsu Hospital, Osaka.
Nihon Rinsho. 1992 Sep;50(9):2173-7.
Disturbance in acid-base balance is commonly observed in patients with heart failure. The most common disturbance is metabolic alkalosis combined with hypokalemia, as a result of the excessive use of loop diuretics. Occasionary, hypoxia due to pulmonary edema stimulates ventilation, resulting in respiratory alkalosis. When pulmonary edema develops, carbon dioxide retention occurs, resulting in respiratory acidosis. Decreased tissue oxygen delivery may also produce lethal lactic acidosis. Compensatory mechanisms, coexistence of independent acid-base disorders and changes in electrolytes complicate acid-base balance in the individual patients. As acid-base disturbances have harmful effects on the cardiovascular system, precise diagnosis and proper treatment are highly important.
心力衰竭患者常出现酸碱平衡紊乱。最常见的紊乱是代谢性碱中毒合并低钾血症,这是过度使用袢利尿剂的结果。偶尔,肺水肿导致的低氧血症会刺激通气,导致呼吸性碱中毒。当肺水肿发生时,会出现二氧化碳潴留,导致呼吸性酸中毒。组织氧输送减少也可能导致致命的乳酸性酸中毒。代偿机制、独立酸碱紊乱的共存以及电解质变化使个体患者的酸碱平衡变得复杂。由于酸碱紊乱对心血管系统有有害影响,准确诊断和恰当治疗非常重要。