...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of Clinical and Diagnostic Research >History of Medical Understanding and Misunderstanding of Acid Base Balance
【24h】

History of Medical Understanding and Misunderstanding of Acid Base Balance

机译：医学认识和对酸碱平衡的误解的历史

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

To establish how controversies in understanding acid base balance arose, the literature on acid base balance was reviewed from 1909, when Henderson described how the neutral reaction of blood is determined by carbonic and organic acids being in equilibrium with an excess of mineral bases over mineral acids. From 1914 to 1930, Van Slyke and others established our acid base principles. They recognised that carbonic acid converts into bicarbonate all non-volatile mineral bases not bound by mineral acids and determined therefore that bicarbonate represents the alkaline reserve of the body and should be a physiological constant. They showed that standard bicarbonate is a good measure of acidosis caused by increased production or decreased elimination of organic acids. However, they recognised that bicarbonate improved low plasma bicarbonate but not high urine acid excretion in diabetic ketoacidosis, and that increasing pCO2 caused chloride to shift into cells raising plasma titratable alkali. Both indicate that minerals influence pH. In 1945 Darrow showed that hyperchloraemic metabolic acidosis in preterm infants fed milk with 5.7 mmol of chloride and 2.0 mmol of sodium per 100 kcal was caused by retention of chloride in excess of sodium. Similar findings were made but not recognised in later studies of metabolic acidosis in preterm infants. Shohl in 1921 and Kildeberg in 1978 presented the theory that carbonic and organic acids are neutralised by mineral base, where mineral base is the excess of mineral cations over anions and organic acid is the difference between mineral base, bicarbonate and protein anion. The degree of metabolic acidosis measured as base excess is determined by deviation in both mineral base and organic acid from normal.
机译：为了确定如何引起理解酸碱平衡的争议，从1909年起回顾了有关酸碱平衡的文献，当时亨德森（Henderson）描述了血液中性反应是如何通过碳酸和有机酸与矿物酸中过量的矿物碱达到平衡来确定的。从1914年到1930年，Van Slyke等人建立了我们的酸碱原理。他们认识到，碳酸将所有不受矿物酸结合的非挥发性矿物碱转化为碳酸氢盐，因此确定碳酸氢盐代表着人体的碱性储备，应为生理常数。他们表明，标准的碳酸氢盐是增加产量或减少有机酸消除导致酸中毒的有效方法。但是，他们认识到，碳酸氢盐改善了糖尿病性酮症酸中毒时血浆中的碳酸氢盐含量低，但尿酸排泄率不高，而增加的pCO2会使氯化物转移到细胞内，从而增加了血浆可滴定的碱度。两者都表明矿物质会影响pH值。在1945年，达罗（Darrow）发现，每100大卡牛奶中含有5.7毫摩尔氯化物和2.0毫摩尔钠的牛奶喂养的早产儿，高氯酸代谢性酸中毒是由于过量的氯化钠滞留造成的。在以后的早产儿代谢性酸中毒的研究中也得到了类似的发现，但并未得到认可。 Shohl（1921）和Kildeberg（1978）提出了一种理论，即碳酸和有机酸被矿物碱中和，其中矿物碱是矿物阳离子比阴离子过量，而有机酸是矿物碱，碳酸氢根和蛋白质阴离子之间的差异。代谢性酸中毒的程度（以碱过量衡量）取决于矿物碱和有机酸与正常水平之间的偏差。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号