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[Acid-base disturbances in surgical operation].

T Ichikura1, S Tamakuma

  • 1National Defense Medical College, Department of Surgery I.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|September 1, 1992
PubMed
Summary

Surgical stress initially causes lactic acidosis due to tissue ischemia. This is often followed by metabolic alkalosis from hormonal changes and fluid administration, impacting acid-base balance post-surgery.

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Area of Science:

  • Physiology
  • Biochemistry
  • Surgical Medicine

Context:

  • Metabolic acidosis and alkalosis are common post-surgical complications.
  • Understanding the dynamic acid-base shifts is crucial for patient management.
  • Surgical stress, tissue ischemia, and therapeutic interventions significantly influence these shifts.

Purpose:

  • To elucidate the mechanisms behind immediate postoperative metabolic acidosis and subsequent alkalosis.
  • To identify key factors contributing to acid-base disturbances in the perioperative period.
  • To provide insights into the management of metabolic complications following surgery.

Summary:

  • Postoperative metabolic acidosis, primarily lactic acidosis, arises from surgical stress and tissue ischemia.
  • Metabolic alkalosis often follows, driven by secondary aldosteronism and bicarbonate buffering from infusions.
  • Specific surgical contexts like gastrointestinal or cardioaortic procedures present unique acid-base challenges.
  • Complications such as shock, renal failure, and respiratory insufficiency can precipitate or exacerbate acidosis.

Impact:

  • Informed clinical decision-making for managing acid-base balance in surgical patients.
  • Improved understanding of the physiological responses to surgical interventions.
  • Potential for developing targeted strategies to mitigate adverse metabolic consequences.
  • Enhanced patient outcomes through better perioperative care and complication management.

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