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عمومی::
اسیدوز، اسیدوز
In contrast with respiratory acidosis, acute systemic metabolic acidosis has little immediate effect on CBF because the BBB excludes H+ from the perivascular space.
The response to hypoxia is synergistic with the hyperemia produced by hypercapnia and acidosis.
Etomidate is effective in reducing ICP without causing a reduction in CPP in patients with intracranial tumors93 and patients with head injuries.94 However, the adminis- tration of etomidate resulted in an exacerbation of brain tis- sue hypoxia and acidosis in patients in whom the MCA was temporarily occluded during surgery.95 Additional con- cerns regarding the occurrence of adrenocortical suppres- sion caused by enzyme inhibition and renal injury caused by the propylene glycol vehicle96 will probably preclude more than episodic use.
In patients subjected to temporary intracranial vessel occlusion, the admin- istration of etomidate results in greater tissue hypoxia and acidosis than equivalent desflurane anesthesia.
Dur- ing generalized seizure activity, CMR and CBF may increase dramatically.187 The intensive motor and brain activity associated with generalized seizures leads to the develop- ment of systemic and cerebral acidosis, often accompanied by a reduction in arterial oxygenation, an increase in Paco2, and peripheral lactic acidosis.،These infants are more likely to experience arterial hypox- emia and acidosis during delivery because of umbilical cord compression.
Conversely, fetal distress resulting from arterial hypoxemia, acidosis, or central nervous system damage is associated with minimal to absent beat-to-beat variability.
When this pattern persists, there is a predictable correlation with devel- opment of fetal acidosis.
Severe variable decelera- tion patterns that persist for 15-30 minutes are associated with fetal acidosis.
Acidosis and pulmonary vasoconstriction are the most likely causes of persistent cyanosis.
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