Sood Pramod, Paul Gunchan, Puri Sandeep
Critical Care Division, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Indian J Crit Care Med. 2010 Apr;14(2):57-64. doi: 10.4103/0972-5229.68215.
Disorders of acid-base balance can lead to severe complications in many disease states, and occasionally the abnormality may be so severe as to become a life-threatening risk factor. The process of analysis and monitoring of arterial blood gas (ABG) is an essential part of diagnosing and managing the oxygenation status and acid-base balance of the high-risk patients, as well as in the care of critically ill patients in the Intensive Care Unit. Since both areas manifest sudden and life-threatening changes in all the systems concerned, a thorough understanding of acid-base balance is mandatory for any physician, and the anesthesiologist is no exception. However, the understanding of ABGs and their interpretation can sometimes be very confusing and also an arduous task. Many methods do exist in literature to guide the interpretation of the ABGs. The discussion in this article does not include all those methods, such as analysis of base excess or Stewart's strong ion difference, but a logical and systematic approach is presented to enable us to make a much easier interpretation through them. The proper application of the concepts of acid-base balance will help the healthcare provider not only to follow the progress of a patient, but also to evaluate the effectiveness of care being provided.
酸碱平衡紊乱可在许多疾病状态下导致严重并发症，偶尔这种异常可能会严重到成为危及生命的危险因素。分析和监测动脉血气（ABG）的过程是诊断和管理高危患者氧合状态及酸碱平衡的重要组成部分，也是重症监护病房中危重症患者护理的重要组成部分。由于这两个领域在所有相关系统中都会出现突然且危及生命的变化，因此任何医生都必须全面了解酸碱平衡，麻醉医生也不例外。然而，对动脉血气及其解读的理解有时可能非常令人困惑，也是一项艰巨的任务。文献中有许多方法可指导动脉血气的解读。本文的讨论不包括所有这些方法，如碱剩余分析或斯图尔特强离子差分析，但将介绍一种逻辑且系统的方法，使我们能够通过这些方法进行更轻松的解读。正确应用酸碱平衡的概念不仅有助于医护人员跟踪患者的病情进展，还能评估所提供护理的效果。
