Zusammenfassung
Die Ursache der Azidose im Rahmen einer schweren Sepsis, bzw. septischen Schocks besteht einerseits in einer intrazellulären Akkumulation von H+ Ionen vorwiegend aus der ATP Hydrolyse (metabolische Azidose), einer verminderten renalen Elimination bei Nierenversagen (metabolische Azidose) und bei zusätzlich schwerster respiratorischer Insuffizienz in einer verminderten CO2 Elimination (respiratorische Azidose).
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Literatur
Bersin RM, Chatterjee K, Arieff Al (1989) Metabolic and hemodynamic consequences of sodium bicarbonate administration in patients with heart disease. Am J Med 87: 7–14
Cingolani HE, Faulkner SL, Mattiazzis AR, Bender HW, Graham TP (1975) Depression of human myocardial contractility with respiratory and metabolic acidosis. Surgery 77: 427–432
Davies AO (1984) Rapid desensitization and uncoupling of human ß-adrenergic receptors in an in vitro model of lactic acidosis. J Clin Endocrinol Metabol 59: 398–405
Effron MB, Guarnieri T, Frederiksen JW, Greene HL, Weisfeldt ML (1978) Am J Physiol 235: H 167–174
Gores GG, Nieminen AL, Wray BE, Herman B, Lemasters JJ (1989) Intracellular pH during „Chemical Hypoxia“ in cultured rat hepatocytes. Protection by intracellular acidosis against onset of cell death. J Clin Invest 83: 386–396
Hickling KG, Henderson SJ, Jackson R (1980) Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 16: 372–377
Kucera R, Whalen W, Shapiro JI (1991) Electroenzephalographic consequences of alkalanization therapy during lactic acidosis: different effects of sodium bicarbonate and carbicarb. J Crit Care 6: 71–74
Landow L, Leung J, Heard SO, Franke M, Mangano D, Arieff Al (1993) Prospective randomized double blind multicenter study of NaHCO3 versus Carbicarb in the treatment of metabolic acidosis. Anesth Analg k76: 205
Madl C, Kranz A, Liebisch B, Traindl O, Lenz K, Druml W (1993) Lactic acidosis in thiamine deficiency. Clin Nutr 12: 108–111
Mark NH, Leund JM, Arieff Al, Mangano DT (1993) Safety of low-dose intraoperative bicarbonate therapy: a prospective, double-blind, randomized study. Crit Care Med 21: 659–665
Mathieu D, Neviere R, Billard V, Fleyfel M, Wattel F (1991) Effects of bicarbonate therapy on hemodynamics and tissue oxygenation in patients with lactic acidosis: a prospective, controlled clinical study. Crit Care Med 19: 1352–1356
Ng M, Levy ML, Zieske HA (1967) Effects of changes of pH and of carbon dioxide tension on left ventricular performance. Am J Physiol 213: 115–120
Sonett J, Baker LS, Hsi C, Knox MA, Visner MS, Landow L (1993) Sodium bicarbonate versus carbicarb in canine myocardial hypercarbic acidosis. J Crit Care 8: 1–11
Stapcoole PW, Wright EC, Baumgartner TG, Bersin RM, Buchhalter S, Curry SH, Duncan CA, Harman EM, Lorenz A, Schneider SH, Siegel JH, Summer WR, Thompson D, Wolfe CL, Zorovich B (1992) A controlledtrial of dichloroacetate for treatment of lactic acidosis in adults. N Engl J Med 327: 1564–1569
Weingad KW, Fettman MJ, Philips RW, Hand MS (1986) Metabolic effects of sodium dichloroacetae in endotoxemic minipigs. Cire Chock 19: 55–67
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© 1994 Springer-Verlag/Wien
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Lenz, K. (1994). Therapie der Azidose bei Sepsis. In: Kleinberger, G., Lenz, K., Ritz, R., Schneeweiß, B., Schuster, HP., Waldhäusl, W. (eds) Metabolismus. Intensivmedizinisches Seminar, vol 7. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9342-6_9
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