Acidosis: main causes, symptoms and treatment
Acidosis is a violation of the acid-base balance of the blood with the accumulation of hydrogen ions and acidic components in its composition. If the body is healthy, then the buffer systems of the blood quickly neutralize the excess of these substances. However, with some diseases or malfunctions in its work, acidic products begin to accumulate in excess amounts in the blood, enter the urine and can even provoke the development of a coma.
Acids begin to accumulate in the body when it produces them in too large a volume, or is unable to fully utilize them. The pH level drops and acidosis develops. Moreover, acidosis is not an independent pathology, this condition is only a consequence of various diseases or disorders in the normal functioning of the body.
The pH range of 7.35-7.38 is considered to be the boundaries of the normal blood acidity for humans. If these boundaries are exceeded, then a person develops serious health problems: hemostasis suffers, the work of internal organs is disrupted, sometimes there are such disorders that pose a direct threat to human life. Therefore, it is important for doctors to know the level of blood acidity of those patients who are in serious condition, for example, in the intensive care unit, in the department of oncological hospitals. Sometimes, regular measurements of the level of acidity in the blood of women who are expecting a child are required (if there is a predisposition to such disorders).
There is compensated and decompensated acidosis, relative and absolute. Sometimes the level of acid-base balance changes in one direction or another against the background of stress, strong emotional excitement, with too fast metabolism, etc. However, such fluctuations are quickly eliminated by the body's own reserves (kidneys, lungs, blood buffer systems). In this case, a person does not even have time to notice that he has had a shift in blood pH, since there will be no pathological symptoms.
Improper nutrition and serious errors in the menu can lead to acidification of the blood of a chronic course. This acidosis can be present throughout a person's life. Symptoms of chronic acidosis are either absent or mild, and the quality of human life does not suffer. Insufficient physical activity, stress, constant hypoxia - all these are risk factors that can lead to the development of mild acidosis.
If a person enters an intensive care unit or an intensive care unit, then the level of acidity of his blood is measured without fail. This indicator characterizes the vital activity of the body, and the increase in acids in the blood requires emergency medical care. If you do not provide it, then acidosis will lead to disturbances in the work of the brain, to coma and death.
Content:
- Why does acidosis develop?
- Types of acidosis
- Acidosis symptoms
- Diagnosis and treatment of acidosis
Why does acidosis develop?
Acidosis is a symptom of a disease or disorder in the human body.
Therefore, it is so important to establish the cause that led to blood acidification:
- Feverish conditions that develop against the background of any diseases or other pathological conditions. When the body temperature rises, metabolic processes are launched, which is accompanied by the production of immunoglobulins (proteins produced by the body itself for its own defense). If the body temperature exceeds 38.5 ° C, then these proteins begin to break down, at the same time fats and carbohydrates are destroyed. As a result, the internal environment of the body becomes acidic.
- Disorders of the kidneys.
- Prolonged diarrhea.
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Unbalanced diet or fasting. If the body does not receive nutrients from food, then it seeks to cover the deficit from its own reserves: glycogen, fats, muscles, etc. The destruction of these substances leads to the fact that the pH is disturbed, and the amount of acids increases, as the body itself begins to produce them. Not only fasting, but also the predominance of animal fats, salt, refined foods and carbohydrates in the menu can lead to the development of acidosis. The lack of fiber and micronutrients in the diet affects pH negatively.
- The period of bearing a child. When a woman is pregnant, all her internal organs work in an enhanced mode. Metabolic processes are accelerated to provide the baby with the maximum amount of nutrients. The level of waste products naturally begins to rise, which can lead to acidosis.
- Inflammatory processes in the body, which have caused impaired hyperventilation of the lungs. The worse the ventilation of the lungs, the stronger the acidosis. Respiratory failure, asthma, pneumonia, emphysema can lead to its development. All these conditions provoke the so-called respiratory or respiratory acidosis.
- Heart diseases.
- Diabetes mellitus, thyrotoxicosis.
Types of acidosis
Depending on the pH level of the blood, the following types of acidosis are distinguished:
- Compensated acidosis, in which there are no symptoms of disturbances in the body. In this case, the pH level is equal to 7.35.
- Subcompensated acidosis, which is expressed by arrhythmia, shortness of breath, diarrhea and vomiting. In this case, the pH level is equal to 7.25.
- Decompensated acidosis, which is characterized by severe interruptions in the work of the heart, digestive system, brain, loss of consciousness. In this case, the pH is 7.24.
Depending on the cause that led to the development of acidosis, the following types are distinguished:
- Metabolic acidosis, which manifests itself in case of disruptions in metabolic processes. When the blood cannot bind normally, or its acids are destroyed, for example, against the background of diabetes mellitus.
- Gas acidosis, when there are disturbances in the process of gas exchange in the lungs. This is caused by diseases of the respiratory system. In addition, respiratory acidosis is observed with hypoventilation of the lungs, with an excessive content of carbon dioxide in the air, with injuries of the chest, etc.
- Non-gaseous acidosis.
- Excretory or excretory acidosis, when the kidneys lose the ability to normally excrete acids from the body (those acids that are dissolved in the blood). Also, excretory acidosis develops if the stomach or intestines secrete too much alkali.
- Exogenous acidosis, which develops under the condition that acids come from the external environment in such volumes that the body is unable to assimilate them.
- Mixed acidosis develops when the internal environment of the body becomes acidic due to several factors of influence at once. For example, against the background of heart disease, which is accompanied by damage to the lungs or kidneys.
Metabolic acidosis
More often than other types of violations of the acid-base balance of the blood, it is metabolic acidosis that occurs. At the same time, the level of lactic, acetoacetic and beta-hydroxymolar acid rises in the blood. The disease has a more severe course, as it is accompanied by an increase in the level of potassium in the blood and a decrease in hemoperfusion in the kidneys.
With diabetes mellitus, the body most often develops ketoacidosis and lactic acidosis, which are characterized by the accumulation of certain types of acids in the blood. So, with lactic acidosis, a lot of lactate accumulates in the blood, and with ketoacidosis, the level of acetoacetic acid, or rather, the products of its decay, increases. These types of acidosis can cause the patient to fall into a coma. Therefore, help should be provided to a person as quickly as possible. Also, lactic acidosis can develop in people who do not play sports, but have experienced strong physical overload. Lactic acid is deposited in the muscles, causing pain, and it also rises in the blood, making it acidic.
Thyrotoxicosis, refusal to eat, and excessive drinking can provoke metabolic acidosis.
Acidosis symptoms
If acidosis is compensated by the adaptive mechanisms of the body, then its symptoms may be absent altogether, or be mild. As acids accumulate in the blood, signs of acid-base imbalance will appear, such as: increased fatigue and weakness, breathing problems. Shock and coma develop with severe acidosis.
Often, the symptoms of acidosis go unnoticed because the symptoms of the underlying disease from which the person suffers prevail over them. This does not allow the correct diagnosis. Severe acidosis is accompanied by respiratory failure, a decrease in the number of heart contractions, cardiogenic shock, and coma.
With metabolic acidosis, violations of the respiratory system are observed according to the Kussamaul type: the inhalation becomes deep, and during exhalation, an excess amount of carbon dioxide is released into the external environment. Thus, the body tries to get rid of excess acid.
Against the background of respiratory acidosis, alveolar gas exchange decreases, breathing becomes shallow, but frequent. It is enough for a specialist to assess the patient's breathing pattern in order to determine the presence of acidosis. The next step is to find out the cause.
Respiratory acidosis is easier to diagnose than others. It is often accompanied by pulmonary emphysema, pneumonia, pulmonary interstitial edema. To identify metabolic acidosis, laboratory and instrumental studies are required.
If a person has compensated acidosis, then it can be detected only after passing a blood test to assess its buffer systems, passing urine, etc. When acidosis begins to intensify, disorders of the respiratory system appear.
If the acidosis is decompensated, then the performance of the brain, cardiovascular system, and digestive organs suffers. These disorders are caused by hypoxia of organ tissues against the background of accumulation of acids in the blood. The obvious symptoms of acidosis are an increase in blood pressure and tachycardia, which develop against the background of an increase in the level of norepinephrine and adrenaline in the blood.
Vomiting and diarrhea indicate the progression of acidosis, since against its background there is an increase in the secretion of the digestive glands. The pressure can either rise or fall, the pulse quickens, arrhythmia and bronchial spasm develop.
Neurological symptoms are manifested by increased drowsiness and fatigue, consciousness becomes clouded, a person becomes apathetic, and experiences a headache. If acidosis is severe, the patient may fall into a coma. At the same time, his pupils will be dilated, there is no reaction to light, reflexes disappear, muscle tone decreases.
The characteristic symptoms of respiratory acidosis are clammy sweat, facial swelling, and a change in skin color from bluish to pink. At first, a person speaks a lot, is in euphoria, but as the acidosis progresses, he falls into apathy, he can go to sleep. Stupor and coma develop with decompensated acidosis. Further progression of violations in the work of the respiratory system leads to more and more pronounced tissue hypoxia, to oppression of the respiratory center. Metabolic disturbances will begin to accompany severe respiratory acidosis. Tachycardia increases, heart rate is not restored. If there is no adequate medical care, then the person dies.
With uremia, against the background of impaired renal function, the patient develops convulsions, since the level of calcium in the blood falls. Breathing becomes noisy and an ammonia odor may come from the mouth as blood urea rises.
Diagnosis and treatment of acidosis
Diagnostic signs that indicate that the blood pH level has dropped to 7.35: an increase in carbon dioxide pressure (respiratory acidosis), a decrease in the level of standard bicarbonate and alkalis (metabolic acidosis). You can deduce these indicators by performing a blood and urine test in the laboratory.
If acidosis has a mild course, then the patient is prescribed an abundant drink, alkaline solutions. It is imperative to correct the menu by removing products from it that promote the growth of acids in the blood. The patient must be carefully examined to determine what is the cause of the acidosis.
The fact that acidification of the internal environment of the body becomes the cause of various diseases is being said more and more in recent years. People who are fond of alternative medicine try to use baking soda to treat every disease, without exception, but is it really universal?
If a person's body grows and develops a malignant neoplasm, then it is simply impossible to cope with it with the help of soda. Moreover, its use will only aggravate the patient's condition. With gastritis, soda will complicate the course of the disease and may even lead to the development of atrophy of the gastric wall. Baking soda can help treat alkalosis. However, it must be taken under the control of laboratory blood parameters and in doses verified together with the doctor.
If acidosis is caused by diabetes mellitus, then the patient should adjust the dose of insulin. Bronchodilators (Salbutamol, Isoprenaline, Theophylline) and mucolytics (Ambroxol, Acetylcysteine) are prescribed for diseases of the respiratory system. It is imperative to sanitize the respiratory system, carry out therapy aimed at restoring the patency of the bronchi.
To eliminate the symptoms of acidosis, the patient is prescribed an abundant drink and soda. If the patient's condition is serious, then a sterile bicarbonate solution is injected intravenously. The procedure is carried out in the intensive care unit.
The author of the article: Shutov Maxim Evgenievich | Hematologist
Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.
