酸塩基平衡異常

WordNet

any of various water-soluble compounds capable of turning litmus blue and reacting with an acid to form a salt and water; "bases include oxides and hydroxides of metals and ammonia" (同)alkali
(numeration system) the positive integer that is equivalent to one in the next higher counting place; "10 is the radix of the decimal system" (同)radix
the bottom side of a geometric figure from which the altitude can be constructed; "the base of the triangle"
situate as a center of operations; "we will base this project in the new lab"
a place that the runner must touch before scoring; "he scrambled to get back to the bag" (同)bag
installation from which a military force initiates operations; "the attack wiped out our forward bases" (同)base of operations
a support or foundation; "the base of the lamp" (同)pedestal, stand
(electronics) the part of a transistor that separates the emitter from the collector
a flat bottom on which something is intended to sit; "a tub should sit on its own base"
the principal ingredient of a mixture; "glycerinated gelatin is used as a base for many ointments"; "he told the painter that he wanted a yellow base with just a hint of green"; "everything she cooked seemed to have rice as the base"
the place where you are stationed and from which missions start and end (同)home
(anatomy) the part of an organ nearest its point of attachment; "the base of the skull"
the bottom or lowest part; "the base of the mountain"
illegitimate (同)baseborn
of low birth or station (`base is archaic in this sense); "baseborn wretches with dirty faces"; "of humble (or lowly) birth" (同)baseborn, humble, lowly
not adhering to ethical or moral principles; "base and unpatriotic motives"; "a base, degrading way of life"; "cheating is dishonorable"; "they considered colonialism immoral"; "unethical practices in handling public funds" (同)immoral
having or showing an ignoble lack of honor or morality; "that liberal obedience without which your army would be a base rabble"- Edmund Burke; "taking a mean advantage"; "chokd with ambition of the meaner sort"- Shakespeare; "something essentially vulgar and meanspirited in politics" (同)mean, meanspirited
(used of metals) consisting of or alloyed with inferior metal; "base coins of aluminum"; "a base metal"
debased; not genuine; "an attempt to eliminate the base coinage"
street name for lysergic acid diethylamide (同)back breaker, battery-acid, dose, dot, Elvis, loony toons, Lucy in the sky with diamonds, pane, superman, window pane, Zen
any of various water-soluble compounds having a sour taste and capable of turning litmus red and reacting with a base to form a salt
having the characteristics of an acid; "an acid reaction"
a lack of balance or state of disequilibrium; "a hormonal imbalance" (同)instability, unbalance
having a base; "firmly based ice"
having a base of operations (often used as a combining form); "a locally based business"; "an Atlanta-based company"; "carrier-based planes"

PrepTutorEJDIC

《文》(人や人の行動・孝えが)『卑しい』,下劣な / (金属が)質の劣った;(貨幣が)粗悪な
『基礎』,根拠 / 『基部』,基底,土台 / 『根拠地』,基地 / (野球の)塁,ベース / 主成分;塩基(酸と反応シテ塩(官)を生じる化合物) / (数学で図形の)底;底辺;基線 / (…に)…‘の'『基礎をおく』《+『名』+『on』(『upon』)+『名』》
酸性の / 酸味のある,すっぱい(sour) / (言葉・態度などが)厳しい,しんらつな / 酸 / すっぱいもの / 《俗》=LSD
不均衡,釣り合いがとれていないこと
basisの複数形

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/28 17:43:13」(JST)

wiki en

Acid–base imbalance is an abnormality of the human body's normal balance of acids and bases that causes the plasma pH to deviate out of the normal range (7.35 to 7.45). In the fetus, the normal range differs based on which umbilical vessel is sampled (umbilical vein pH is normally 7.25 to 7.45; umbilical artery pH is normally 7.18 to 7.38).^[1] It can exist in varying levels of severity, some life-threatening.

Classification

A Davenport diagram illustrates acid–base imbalance graphically.

An excess of acid is called acidosis or acidaemia and an excess in bases is called alkalosis or alkalemia. The process that causes the imbalance is classified based on the etiology of the disturbance (respiratory or metabolic) and the direction of change in pH (acidosis or alkalosis). This yields the following four basic processes:

process	pH	carbon dioxide	compensation
metabolic acidosis	down	down	respiratory
respiratory acidosis	down	up	renal
metabolic alkalosis	up	up	respiratory
respiratory alkalosis	up	down	renal

Mixed disorders

The presence of only one of the above derangements is called a simple acid–base disorder. In a mixed disorder more than one is occurring at the same time.^[2] Mixed disorders may feature an acidosis and alkosis at the same time that partially counteract each other, or there can be two different conditions affecting the pH in the same direction. The phrase "mixed acidosis", for example, refers to metabolic acidosis in conjunction with respiratory acidosis. Any combination is possible, except concurrent respiratory acidosis and respiratory alkalosis, since a person cannot breathe too fast and too slow at the same time.

Calculation of imbalance

The traditional approach to the study of acid–base physiology has been the empiric approach. The main variants are the base excess approach and the bicarbonate approach. The quantitative approach introduced by Peter A Stewart in 1978^[3] is newer.

Causes

There are numerous reasons that each of the four processes can occur (detailed in each article). Generally speaking, sources of acid gain include:

Retention of carbon dioxide
Production of nonvolatile acids from the metabolism of proteins and other organic molecules
Loss of bicarbonate in feces or urine
Intake of acids or acid precursors

Sources of acid loss include:

Use of hydrogen ions in the metabolism of various organic anions
Loss of acid in the vomitus or urine
Gastric aspiration in hospital
Severe diarrhea

Compensation

The body's acid–base balance is tightly regulated. Several buffering agents exist which reversibly bind hydrogen ions and impede any change in pH. Extracellular buffers include bicarbonate and ammonia, while proteins and phosphate act as intracellular buffers. The bicarbonate buffering system is especially key, as carbon dioxide (CO₂) can be shifted through carbonic acid (H₂CO₃) to hydrogen ions and bicarbonate (HCO₃⁻) as shown below.

Acid–base imbalances that overcome the buffer system can be compensated in the short term by changing the rate of ventilation. This alters the concentration of carbon dioxide in the blood, shifting the above reaction according to Le Chatelier's principle, which in turn alters the pH. For instance, if the blood pH drops too low (acidemia), the body will compensate by increasing breathing, expelling CO₂, and shifting the reaction above to the right such that fewer hydrogen ions are free – thus the pH will rise back to normal. For alkalemia, the opposite occurs.

The kidneys are slower to compensate, but renal physiology has several powerful mechanisms to control pH by the excretion of excess acid or base. In responses to acidosis, tubular cells reabsorb more bicarbonate from the tubular fluid, collecting duct cells secrete more hydrogen and generate more bicarbonate, and ammoniagenesis leads to increased formation of the NH₃ buffer. In responses to alkalosis, the kidney may excrete more bicarbonate by decreasing hydrogen ion secretion from the tubular epithelial cells, and lowering rates of glutamine metabolism and ammonia excretion.

References

^ Yeomans, ER; Hauth, JC; Gilstrap, LC III; Strickland DM (1985). "Umbilical cord pH, PCO2, and bicarbonate following uncomplicated term vaginal deliveries (146 infants)". Am J Obstet Gynecol 151 (6): 798–800. doi:10.1016/0002-9378(85)90523-x. PMID 3919587.
^ "Mixed Acid Base Disorders: Acid Base Tutorial, University of Connecticut Health Center". Archived from the original on 26 April 2009. Retrieved 2009-05-09.
^ Stewart P (1978). "Independent and dependent variables of acid-base control". Respir Physiol 33 (1): 9–26. doi:10.1016/0034-5687(78)90079-8. PMID 27857.

External links

On-line text at AnaesthesiaMCQ.com
Physiology: 7/7ch12/7ch12lin - Essentials of Human Physiology
Overview at kumc.edu
Overview at mcgill.ca
[1]
Stewart's original text at acidbase.org
Overview at med.utah.edu
Overview at anaesthetist.com
Overview at anst.uu.se
Tutorial at acid-base.com
Online acid–base physiology text
Diagnoses at lakesidepress.com
Interpretation at nda.ox.ac.uk
Acid Base Tutorial

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 動脈血液ガス arterial blood gases
2. 単純性および混合性酸塩基障害 simple and mixed acid base disorders
3. 出産時の臍帯血酸塩基分析 umbilical cord blood acid base analysis at delivery
4. 最新の診療アップデート practice changing updates
5. 先天性代謝異常：代謝性救急疾患 inborn errors of metabolism metabolic emergencies

English Journal

Acid-base problems in diabetic ketoacidosis.

Frontino G, Rigamonti A, Bonfanti R.
The New England journal of medicine.N Engl J Med.2015 May 14;372(20):1969. doi: 10.1056/NEJMc1502745#SA3.
PMID 25970066

Acid-base problems in diabetic ketoacidosis.

Maury E, Bureau C, Offenstadt G.
The New England journal of medicine.N Engl J Med.2015 May 14;372(20):1968-9. doi: 10.1056/NEJMc1502745#SA2.
PMID 25970065

Acid-base problems in diabetic ketoacidosis.

Joy M.
The New England journal of medicine.N Engl J Med.2015 May 14;372(20):1968. doi: 10.1056/NEJMc1502745#SA1.
PMID 25970064

Japanese Journal

めまいと酸塩基平衡障害

Equilibrium research 72(3), 145-155, 2013-06-01
NAID 10031183105

Glucose administration during volume resuscitation using dextran-40 from hemorrhagic shock ameliorates acid/base-imbalance in fasted rats under sevoflurane anesthesia

BioScience Trends 7(3), 138-143, 2013
NAID 130004572591

Gitelman's Syndrome with Vomiting Manifested by Severe Metabolic Alkalosis and Progressive Renal Insufficiency

The Tohoku Journal of Experimental Medicine 231(3), 165-169, 2013
NAID 130004460092

Related Pictures

★リンクテーブル★

リンク元	「酸塩基平衡異常」
関連記事	「base」「imbalance」

「酸塩基平衡異常」

Blood gas, acid-base, & gas exchange terms
PaO2	Arterial oxygen tension, or partial pressure
PAO2	Alveolar oxygen tension, or partial pressure
PaCO2	Arterial carbon dioxide tension, or partial pressure
PACO2	Alveolar carbon dioxide tension, or partial pressure
PvO2	Oxygen tension of mixed venous blood
P(A-a)O2	Alveolar-arterial oxygen tension difference. The term formerly used (A-a DO2) is discouraged.
P(a/A)O2	Alveolar-arterial tension ratio; PaO2:PAO2 The term oxygen exchange index describes this ratio.
C(a-v)O2	Arteriovenous oxygen content difference
SaO2	Oxygen saturation of the hemoglobin of arterial blood
SpO2	Oxygen saturation as measured by pulse oximetry
CaO2	Oxygen content of arterial blood
pH	Symbol relating the hydrogen ion concentration or activity of a solution to that of a standard solution; approximately equal to the negative logarithm of the hydrogen ion concentration. pH is an indicator of the relative acidity or alkalinity of a solution
	v; t; e;

Acid–base imbalance
Classification and external resources
ICD-10	E87.2-E87.4
ICD-9	276.2-276.4
MeSH	D000137

　　[★]

英: acid-base imbalance, acid-base balance disturbance, acid-base balance disorder
同: 酸塩基平衡障害
関: 酸塩基平衡