Significance of pH changes of arterial blood in patients with acute left heart failure / 中国综合临床

ABSTRACT

Objective To investigate the pH changes of arterial blood in patients with acute left heart failure.Methods Thirty-eight patients with acute left heart failure were selected as our subjects,who all underwent diuresis,the strong heart diuresis,dilation of blood vessels,reducing the load on the heart,and making water and electrolyte balance of conventional medication,and then parallel oxygen mask,respirator mode synchronized intermittent mandatory ventilation(SIMV).If hypoxia was not significantly improved,and positive pressure ventilation with end expiratory(PEEP) treatment was conducted.Results After treatment,the level of pH,heart rate(HR),breathing rate(RR),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2) and mean arterial pressure(MAP) were (7.4 ± 0.3,86.3 ± 6.2) times/min,(22.5 ±4.8) times/min,(84.8 ±7.3) mmHg,(43.3 ±5.5) mmHg,(81.1 ±3.2) mmHg,different from those before treatment(7.1 ±0.1),(118.3 ±8.2) times/min,(36.2 ±7.1) times/min,(47.2 ±6.6) mmHg,(48.3 ±5.2) mmHg,(96.2 ±4.5) mmHg),and the differences were significant (t =5.848,19.188,9.854,23.552,4.072,16.857 respectively; P ＜ 0.01).With the progress of treatment,pH value and pHi value in patients showed a rising trend.Regression analysis showed a positive correlation and the regression equation was Y =-0.559 4 + 1.103 7X.Conclusion Patients with acute left heart failure show abnormal blood pH level and the corresponding change inside red blood cells.Then it causes changes in arterial blood oxygen carrying capacity of red blood cells,reduces the cell through the capillary capacity.Therefore,it can result in decrease of gas exchange levels in patients and hypoxia.Treatment should be considered imbalance the body of the improved state of acid-base.