Acidosis

I-Acidosis yimeko apho kukho i-asidi eninzi kulwelo lomzimba. Kukuchasene nealkalosis (imeko apho kukho isiseko esininzi kakhulu kulwelo lomzimba).

Izintso nemiphunga zigcina ibhalansi (inqanaba le-pH elifanelekileyo) leekhemikhali ezibizwa ngokuba ziiasidi kunye neziseko emzimbeni. I-Acidosis yenzeka xa i-asidi isakha okanye xa i-bicarbonate (isiseko) ilahlekile. I-Acidosis ihlelwa njengokuphefumla okanye i-metabolic acidosis.

Ukuphefumla i-acidosis kuyakhula xa kukho i-carbon dioxide eninzi (i-asidi) emzimbeni. Olu hlobo lwe-acidosis luhlala lubangelwa xa umzimba ungakwazi ukukhupha i-carbon dioxide eyaneleyo ngokuphefumla. Amanye amagama e-acidosis yokuphefumla yi-hypercapnic acidosis kunye ne-carbon dioxide acidosis. Izizathu zokuphefumla i-acidosis zibandakanya:

• Ukukhubazeka kwesifuba, njenge-kyphosis
• Ukulimala kwesifuba
• Ubuthathaka bemisipha yesifuba
• Ixesha elide (elingapheliyo) isifo semiphunga
• Iziphazamiso ze-Neuromuscular, ezifana ne-myasthenia gravis, i-muscular dystrophy
  
• Ukusetyenziswa gwenxa kweziyobisi zokuthomalalisa

I-Metabolic acidosis ikhula xa i-asidi eninzi iveliswa emzimbeni. Inokwenzeka kwakhona xa izintso zingenakususa i-asidi eyaneleyo emzimbeni. Kukho iintlobo ezininzi ze-metosis acidosis:

• Isifo seswekile (esikwabizwa ngokuba sisifo seswekile ketoacidosis kunye ne-DKA) sikhula xa izinto ezibizwa ngokuba yimizimba ye-ketone (ene-asidi) eyakha ngexesha lesifo seswekile esingalawulwayo.
• I-Hyperchloremic acidosis ibangelwa kukuphulukana ne-sodium bicarbonate eninzi emzimbeni, enokwenzeka xa kukho urhudo oluqatha.
• Isifo sezintso (i-uremia, i-distal renal tubular acidosis okanye i-proximal renal tubular acidosis).
• Lactic acidosis.
• Ityhefu yi-aspirin, i-ethylene glycol (efumaneka kwi-antifreeze), okanye i-methanol.
• Ukuphelelwa ngamandla emzimbeni.

I-Lactic acidosis yindawo yokwakha i-lactic acid. I-Lactic acid iveliswa ikakhulu kwiiseli zemisipha kunye neeseli ezibomvu zegazi. Yenzeka xa umzimba wophula iikhabhohayidrethi uzisebenzisele amandla xa amanqanaba eoksijini ephantsi. Oku kunokubangelwa:

• Umhlaza
• Ukusela kakhulu utywala
• Ukuzivocavoca ngamandla ixesha elide
• Ukungaphumeleli kwesibindi
• Iswekile esezantsi yegazi (hypoglycemia)
• Amayeza, afana ne-salicylates, i-metformin, ii-anti-retrovirals
• I-MELAS (isifo esingaqhelekanga semfuza yemithachondrial esichaphazela ukuveliswa kwamandla)
• Ukungabikho kwexesha elide kweoksijini kukothuka, ukusilela kwentliziyo, okanye i-anemia ebukhali
• Ukuxhuzula
• I-Sepsis - isifo esibi ngenxa yosulelo lwebacteria okanye ezinye iintsholongwane
• Ityhefu yecarbon monoxide
• Isifo sombefu esinamandla

Iimpawu zeMetabolic acidosis zixhomekeke kwisifo esisisiseko okanye imeko. I-Metabolic acidosis ngokwayo ibangela ukuphefumla ngokukhawuleza. Ukudideka okanye ukonwaba kunokwenzeka. Ukuchaneka kwe-acidosis kungakhokelela kukothuka okanye ekufeni.

Iimpawu zokuphefumla i-acidosis zinokubandakanya:

• Ukudideka
• Ukudinwa
• Ukuhamba
• Ukuqhawukelwa ngumphefumlo
• Ukulala

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho.

Iimvavanyo zaselebhu ezinoku-odolwa zibandakanya:

• Uhlalutyo lwegesi yegazi
• Iphaneli yokuSisiseko ye-metabolic (iqela leemvavanyo zegazi ezilinganisa amanqanaba esodium kunye ne-potassium, ukusebenza kwezintso, kunye nezinye iikhemikhali kunye nemisebenzi) ukubonisa ukuba uhlobo lwe-acidosis luyinto yemetabolism okanye yokuphefumla.
• Iiketoni zegazi
• Uvavanyo lweLactic acid
• Iiketoni zomchamo
• Umchamo pH

Ezinye iimvavanyo ezinokufuneka ukumisela unobangela we-acidosis zibandakanya:

• I-x-ray yesifuba
• Isisu se-CT
• Uhlalutyo lomchamo
• Umchamo pH

Unyango luxhomekeke kwisizathu. Umboneleli wakho uya kukuxelela ngakumbi.

I-Acidosis inokuba yingozi xa inganyangwa. Amatyala amaninzi asabela kakuhle kunyango.

Iingxaki zixhomekeke kuhlobo oluthile lwe-acidosis.

Zonke iintlobo ze-acidosis ziya kubangela iimpawu ezifuna unyango ngumboneleli wakho.

Ukuthintela kuxhomekeke kwisizathu se-acidosis. Izinto ezininzi ezinokubangela isifo se-metabolic acidosis zinokuthintelwa, kubandakanya isifo seswekile, ketoacidosis kunye noonobangela be-lactic acidosis Ngokwesiqhelo, abantu abanezintso ezinempilo kunye nemiphunga abanayo i-acidosis enzulu.

• Izintso

I-Effros RM, iSwenson ER. Ibhalansi yesiseko se-Acid. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 7.

I-Oh MS, i-Briefel G. Uvavanyo lomsebenzi we-renal, amanzi, ii-electrolyte, kunye ne-acid-base balance. Ku: McPherson RA, Pincus MR, ii-eds. Ukuchongwa kweKlinikhi kaHenry kunye noLawulo ngeendlela zeLebhu. Umhla we-23. ISt Louis, MO: Elsevier; Ngo-2017: isahluko 14.

Seifter JL. Ukuphazamiseka kwesiseko se-Acid. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 110.