I-Acidosis

I-Acidosis yisimo lapho kune-asidi eningi khona emzimbeni wamanzi. Kuphambene ne-alkalosis (isimo lapho kunesisekelo esiningi kakhulu emanzini omzimba).

Izinso namaphaphu kugcina ibhalansi (izinga elifanele le-pH) lamakhemikhali abizwa ngama-acid nezisekelo emzimbeni. I-Acidosis yenzeka lapho i-asidi yakha noma lapho i-bicarbonate (isisekelo) ilahlekile. I-Acidosis ihlukaniswa njengokuphefumula noma i-metabolic acidosis.

I-acidosis yokuphefumula iba lapho kune-carbon dioxide eningi kakhulu (i-asidi) emzimbeni. Lolu hlobo lwe-acidosis luvame ukubangelwa lapho umzimba ungakwazi ukukhipha isikhutha esanele ngokuphefumula. Amanye amagama e-acidosis yokuphefumula yi-hypercapnic acidosis ne-carbon dioxide acidosis. Izimbangela zokuphefumula i-acidosis zifaka:

• Ukukhubazeka kwesifuba, njenge-kyphosis
• Ukulimala kwesifuba
• Ubuthakathaka bemisipha yesifuba
• Isifo samaphaphu sesikhathi eside (esingapheli)
• Ukuphazamiseka kwe-Neuromuscular, njenge-myasthenia gravis, muscular dystrophy
  
• Ukusetshenziswa ngokweqile kwezidakamizwa ezithomalalisayo

I-Metabolic acidosis iba lapho kukhiqizwa i-asidi eningi emzimbeni. Kungenzeka futhi lapho izinso zingakwazi ukukhipha i-asidi eyanele emzimbeni. Kunezinhlobo eziningi ze-metabolic acidosis:

• I-diabetic acidosis (ebizwa nangokuthi i-ketoacidosis yesifo sikashukela kanye ne-DKA) iba lapho izinto ezibizwa ngokuthi yimizimba ye-ketone (eyi-acidic) zakha ngesikhathi sesifo sikashukela esingalawulwa.
• I-Hyperchloremic acidosis ibangelwa wukulahleka kwe-bicarbonate eningi kakhulu emzimbeni, engenzeka ngohudo olunzima.
• Isifo sezinso (i-uremia, i-distal renal tubular acidosis noma i-proximal renal tubular acidosis).
• I-Lactic acidosis.
• Ubuthi nge-aspirin, i-ethylene glycol (etholakala ku-antifreeze), noma i-methanol.
• Ukuphela kwamanzi emzimbeni.

I-Lactic acidosis iyinqwaba ye-lactic acid. I-Lactic acid ikhiqizwa kakhulu kumaseli emisipha namaseli abomvu egazi. Yakha lapho umzimba wephula ama-carbohydrate ukuze uwasebenzisele amandla lapho amazinga e-oxygen ephansi. Lokhu kungabangelwa:

• Umdlavuza
• Ukuphuza kakhulu utshwala
• Ukuzivocavoca ngamandla isikhathi eside kakhulu
• Ukuhluleka kwesibindi
• Ushukela wegazi ophansi (i-hypoglycemia)
• Imithi efana ne-salicylates, i-metformin, ama-anti-retrovirals
• I-MELAS (isifo esingavamile kakhulu se-mitochondrial disorder esithinta ukukhiqizwa kwamandla)
• Ukungabi khona komoya-mpilo isikhathi eside ngenxa yokushaqeka, ukwehluleka kwenhliziyo, noma i-anemia enamandla
• Ukuquleka
• I-Sepsis - ukugula okunzima ngenxa yokutheleleka ngamagciwane noma amanye amagciwane
• Ubuthi be-Carbon monoxide
• Isifuba somoya esibucayi

Izimpawu ze-Metabolic acidosis zincike kwisifo noma isimo. I-Metabolic acidosis ngokwayo ibanga ukuphefumula okusheshayo. Ukudideka noma ukukhathala kungenzeka futhi. I-metabolic acidosis enamandla ingaholela ekushaqekeni noma ekufeni.

Izimpawu zokuphefumula ze-acidosis zingafaka:

• Ukudideka
• Ukukhathala
• Imikhuba emibi
• Ukuphelelwa umoya
• Ukulala

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho.

Ukuhlolwa kwelabhorathri okunga-odwa kufaka phakathi:

• Ukuhlaziywa kwegesi yegazi
• Iphaneli eyisisekelo ye-metabolic (iqembu lezivivinyo zegazi ezilinganisa amazinga e-sodium ne-potassium, ukusebenza kwezinso, namanye amakhemikhali nemisebenzi) ukukhombisa ukuthi ngabe uhlobo lwe-acidosis luyisifo semetabolism
• Amaketanga egazi
• Ukuhlolwa kwe-Lactic acid
• Amaketoni omchamo
• Umchamo pH

Olunye uvivinyo olungadingeka ukuthola imbangela ye-acidosis lubandakanya:

• I-x-ray yesifuba
• Isisu se-CT
• Ukuhlolwa komchamo
• Umchamo pH

Ukwelashwa kuya ngesizathu. Umhlinzeki wakho uzokutshela okuningi.

I-Acidosis ingaba yingozi uma ingalashwa. Amacala amaningi asabela kahle ekwelashweni.

Izinkinga zincike ohlotsheni oluthile lwe-acidosis.

Zonke izinhlobo ze-acidosis zizodala izimpawu ezidinga ukwelashwa ngumhlinzeki wakho.

Ukuvimbela kuncike embangela ye-acidosis. Izimbangela eziningi ze-metabolic acidosis zingavinjelwa, kufaka phakathi i-ketoacidosis yesifo sikashukela nezinye izimbangela ze-lactic acidosis. Imvamisa, abantu abanezinso namaphaphu aphilile abanayo i-acidosis ebucayi.

• Izinso

I-Effros RM, iSwenson ER. Ibhalansi ye-acid-base. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, abakwa-eds. Incwadi kaMurray neNadel Yemithi Yokuphefumula. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 7.

I-Oh MS, i-Briefel G. Ukuhlolwa kokusebenza kwezinso, amanzi, ama-electrolyte, ne-acid-base balance. Ku: McPherson RA, Pincus MR, abahleli. UHenry’s Clinical Diagnosis and Management by Laboratory Methods. Umhla ka-23. ISt Louis, MO: Elsevier; I-2017: isahluko 14.

Seifter JL. Izinkinga ze-acid-base. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 110.