Management of acid-base equilibrium in patients with septic shock - Sistematic Literature Review

Abstract

The acid-base equilibrium is essential for the maintenance of human life. It ensures optimal conditions for cell function, regulating the right amount of hydrogen ions in the blood. In an intensive care unit there are many diseases that alter blood pH, for example, the sepsis. During its evolution, disseminated intravascular coagulation occurs which impairs the body perfusion, resulting in a distributive shock and a potential ischemia of the organs. The arrival of oxygen deficiency in cells stimulates anaerobic metabolism, causing excessive lactate and severely decreasing the blood pH. Given the enormity of the problem, this article aims to answer the clinical question: in the critical patient, which is the effective management of acid-base equilibrium in the treatment of septic shock? This is a literature review through computerized search over the months between April and November 2010. As the most important activities of nursing were shown the control of diuresis, water balance and blood gases analysis. At the end of the study it was concluded that early identification of shock, control of infectious focus, maintenance of tissue perfusion and maintenance of acid-base equilibrium of the septic patient, prevent the development of multiple organ dysfunction, resulting in decreased of mortality.