What causes acidosis

Acidosis is a common cause of diarrhea. But everyone knows that diarrhea is a very common disease, and there are many causes of diarrhea. So how can we determine whether it is caused by acidosis? For this, we invited the chief doctor to give you a popular science explanation about what acidosis is, what signs the patient will have after acidosis, and what causes acidosis.

Acidosis refers to the accumulation of acidic substances in the blood and tissues of the body. Its essence is an increase in the hydrogen ion concentration and a decrease in the pH value in the blood. Under pathological conditions, when [BHCO3] decreases or [H2CO3] increases in the body, the [BHCO3]/[H2CO3] ratio will decrease, causing the pH value of the blood to decrease, which is called acidosis. The accumulation of acid in the blood and tissues of the body, characterized by increased hydrogen ion concentration and decreased pH in the blood.

Clinical manifestations: 1. Breathing becomes deeper and faster, and may have a rotten apple smell. 2. Fatigue, drowsiness, and coma. 3. Flushed face, decreased blood pressure, and rapid heart rate.

What causes acidosis?

1. Metabolic acidosis Metabolic acidosis is characterized by a primary decrease in plasma [HCO-] and a downward trend in pH. Metabolic acidosis can be divided into two categories based on whether the anion gap (AG) is increased:

AG increase type metabolic acidosis, the patient's plasma [Cl-] level is normal, which is often referred to as normoclonal metabolic acidosis in the literature.

In metabolic acidosis with a normal anion gap, the patient's plasma [Cl-] level is elevated, which is often referred to as hyperchloremic metabolic acidosis in the literature.

2. Respiratory acidosis Respiratory poisoning is characterized by an increase in plasma [H2CO3] concentration and a decreasing pH trend.

(1) Inhibition of the respiratory center In some central nervous system diseases such as medullary tumors, medullary poliomyelitis, encephalitis, meningitis, vertebral artery embolism or thrombosis, increased intracranial pressure, craniocerebral trauma, etc., the activity of the respiratory center may be inhibited, resulting in reduced ventilation and accumulation of CO2. In addition, some drugs such as anesthetics, sedatives, and tranquilizers (morphine, sodium barbital, etc.) have the effect of inhibiting breathing, and excessive doses can also cause hypoventilation. Carbonic anhydrase inhibitors such as acetazolamide can cause metabolic acidosis as mentioned above. It can also inhibit carbonic anhydrase in red blood cells and reduce the release of CO2 from red blood cells in the lungs, thereby causing an increase in arterial blood Pco2. This drug should be used with caution in patients with a tendency to acidosis.

(2) Respiratory nerve and muscle dysfunction is seen in poliomyelitis, acute infectious polyneuritis (Guillain-barre syndrome), botulism, myasthenia gravis, hypokalemia or familial periodic paralysis, high spinal cord injury, etc. In severe cases, the respiratory muscles may be paralyzed.

(3) Chest abnormalities Common chest abnormalities that affect respiratory movements include kyphosis, scoliosis, flail chest, ankylosing spondylitis, and Picwick syndrome.

(4) Common causes of airway obstruction include foreign body obstruction, laryngeal edema, and aspiration of vomitus.

(5) Extensive lung disease is the most common cause of respiratory acidosis. It includes chronic obstructive pulmonary disease, bronchial asthma, severe interstitial lung disease, etc. These lesions can seriously impede alveolar ventilation. (6) Excessive CO2 inhalation refers to excessively high CO2 concentration in the inhaled air, such as in tunnels, tanks and other small and poorly ventilated environments. At this time, alveolar ventilation does not decrease.