Ðe wò ŋutilã me acid le akpa? Mina míasrɔ̃ nu tso lactic acidosis ŋu!

Ðe ɖeɖi te ŋuwò, vevesese, alo gbɔgbɔtsixe tsi ƒowò ne ɖeɖi te ŋuwò vie kpɔa? Esiawo ate ŋu atso susu geɖe gbɔ. Ke hã, egbea míele nu ƒom tso nɔnɔme aɖe si ate ŋu adzɔ ne atike aɖe si woyɔna be lactic acid ƒo ƒu ɖe míaƒe ŋutilã me ŋu. Esiae nye nusi ɖɔktawo yɔna be lactic acidosis . Mègatsi dzi o, mina míaƒo nu tso esia ŋu bɔbɔe.

Nukae nye Lactic Acidosis?

Kpuie ko la, lactic acidosis nye nɔnɔme si me lactic acid sɔ gbɔ ɖe wò ʋu me akpa. Esia ate ŋu adzɔ ne wò ŋutilã wɔ lactic acid fũ akpa, alo ne wò ŋutilã mete ŋu ɖe lactic acid si wòwɔna la ɖa nyuie o.

Zi geɖe la, míaƒe aklã kple ayikue ɖea lactic acid si sɔ gbɔ ɖe míaƒe ŋutilã me ɖa. Gake ne lactic acid ƒe agbɔsɔsɔ sɔ gbɔ akpa, alo ne gbɔdzɔgbɔdzɔ aɖe le ŋutinu siawo abe aklã kple ayiku ene me la, womate ŋu awɔ dɔ sia nyuie o. Ɣemaɣie lactic acid dzea ƒoƒo ɖe ʋua me gɔme.

Ne lactic acid ƒe agbɔsɔsɔ le wò ʋu me dzi ɖe edzi vie la, míeyɔnae be hyperlactatemia . Gake ne esia gadzi ɖe edzi eye ŋutilãa ƒe pH (i.e. acid-base balance) va zu acid akpa la, woyɔa ema be lactic acidosis .

Nukatae lactic acid dzɔna le míaƒe ŋutilã me?

Lactic acid, si woyɔna ɣeaɖewoɣi be lactate , nye dzɔdzɔmenu si dona tso lãmenugbagbeviwo ƒe dɔwɔwɔ me. Míaƒe lãmenugbagbeviwo zãa sukli (sukli) tsɔ wɔa ŋusẽ. Woyɔa nuwɔna sia be anaerobic glycolysis . Esia dzɔna ne lãmenugbagbeviwo hiã ŋusẽ kaba, gake oxygen mesɔ gbɔ na wo be woate ŋu awɔe o.

Zi geɖe la, míekpɔa ŋusẽ to mɔnu aɖe si zãa ɔksidzin dzi. Woyɔa esia be aerobic metabolism . Gake anaerobic glycolysis le abe ŋusẽtsoƒe si míezãna le nɔnɔme kpatawo me ene. Bu eŋu kpɔ, ne èƒu du sesĩe kasia alo kɔ agba kpekpe aɖe la, kasia ya si woyɔna be oxygen meganɔa wò lãmekawo me o. Ɣemaɣie wozãa mɔnu sia. Nenema ke ne míaƒe lãmekawo mexɔ ɔksidzin o le dɔléle aɖewo ta la, wowɔa lactic acid hã le mɔ sia nu.

Nukae dzɔna ne lactic acidosis dzɔ?

Nusi dzɔna ne lactic acidosis le ŋuwò nɔ te ɖe eƒe sesẽ dzi. Ame aɖewo ate ŋu ato nɔnɔme sia me hena ɣeyiɣi aɖe, vevietɔ le kamedede sesẽ megbe. Ate ŋu ana wò ŋutilã nase veve ŋkeke ʋɛ aɖewo. Gake ne wò aklã kple ayiku le lãmesẽ me la, lactic acid la nu ayi le ŋkeke ʋɛ aɖewo megbe.

Gake ne wò ŋutilã yi edzi le lactic acid wɔm fũ akpa, alo ne wò aklã kple ayiku mete ŋu trɔa asi le eŋu nyuie o la, nɔnɔmea ate ŋu asẽ ɖe edzi. Esia dzɔna zi geɖe ne dɔléle aɖe ƒomevi le ame ŋu. Ne lactate ƒe agbɔsɔsɔ si le wò ʋu me yi edzi le dzi yim la, pH ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna, eye dzi ƒe dɔwɔwɔ dzi ɖena kpɔtɔna vivivi. Esia ate ŋu ana ŋutinu bubuwo nawɔ dɔ nyuie eye wòaku gɔ̃ hã. Eyata ele vevie be nànya esia.

Nukae nye Lactic Acidosis ƒe dzesiwo?

Nɔnɔme sia ƒe dzesiwo ate ŋu ato vovo le eƒe gɔmedzedze kple ne nɔnɔmea nu sẽ.

Dzesi siwo dzena le gɔmedzedzea me

Gbã la, àte ŋu ase nanewo abe esia ene:

• Aɖuɖɔtoe kple ʋuʋudedi.
• Ðeɖiteameŋu kple ɖeɖiteameŋu si gbɔ eme.
• Yagbɔgbɔ kabakaba, si me goglo (woyɔa esia be gbɔgbɔtsixe ƒe fexexe , si nye agbagbadzedze be woaɖe ŋutilãa ƒe acid dzi akpɔtɔ to gbɔgbɔ me).
• Lãmetsiwo ƒe ʋuʋu kple ŋutilã ƒe vevesese.

Dzesiwo ne nɔnɔmea va nu sẽ

Ne nɔnɔmea le sesẽm ɖe edzi la, dzesi siwo gbɔna hã ate ŋu adze:

• Gbɔdzɔgbɔdzɔ kple alɔ̃dɔdɔ ƒe dzidziɖedzi.
• Delirium kple tɔtɔ.
• Esesẽna be woaɖu ʋuʋu dzi, abe ne wole zɔzɔm ene ( ataxia ).
• Aɖuɖɔ ƒe dodo dzi ɖe kpɔtɔ ( Oliguria ).

Dzesi bubuwo

Atikewɔwɔ me dɔléle aɖe si le ŋuwò si le lactic acidosis hem vɛ ƒe dzesiwo hã ate ŋu anɔ ŋuwò . Le kpɔɖeŋu me, nɔnɔmewo abe sepsis ( ʋumenugbagbeviɣidɔ), dzidziƒoame ( ʋusɔgbɔdɔ), alo aklã ƒe dɔmawɔmawɔ nyuie . Esia ƒe dzesiwo ate ŋu anye:

• Ŋutilã ƒe dzoxɔxɔ si bɔbɔ ɖe anyi.
• Ʋu ƒe sisi ƒe ɖiɖi.
• Asrã.
• Jaundice (ŋutilã ƒe ɣie kple ŋku ƒe ɣie).

Nuka koŋue hea lactic acidosis vɛ?

Susu geɖewo ate ŋu anɔ esia ta. Nusi gbɔ wòtsona wue nye oxygen ƒe agbɔsɔsɔ si medea wò ʋu me o (hypoxemia) alo oxygen ƒe anyimanɔmanɔ na wò lãmenugbagbeviwo (hypoxia). Zi geɖe la, atikewɔwɔ ƒe nɔnɔme aɖe gbɔe esia tsona.

Ðɔktawo ma lactic acidosis ƒe nɔnɔme sia ɖe ƒomevi vovovowo me le nusiwo gbɔ wòtsona nu:

Ƒomevi A

Lactic acidosis ƒomevi A dzɔna ne wò lãkusiwo mekpɔ oxygen si sɔ o. Wokpɔnɛ zi geɖe le atikewɔwɔ ƒe nɔnɔme sesẽwo me. Ate ŋu anɔ anyi ɣeyiɣi kpui aɖe hã, eye kamedede si gbɔ eme gbɔe wòtso.

Nɔnɔme aɖewo siwo ate ŋu ana lactate nawɔ fũ akpa dometɔ aɖewoe nye:

• Aklãdɔléle nana be ʋua mexɔa oxygen si sɔ o.
• Lãmetsiŋusẽ ƒe dɔmawɔmawɔ nyuie nana ʋu sina blewu eye oxygen meganɔa lãmekawo me o.
• Hemoglobin ƒe dɔléle gblẽa nu le ʋumenugbagbevi dzĩwo ƒe ŋutete be woatsɔ oxygen ayi teƒe bubuwo ŋu.
• Nɔnɔme siwo nana ame ƒe dzi gbãna abe septic shock , hypovolemic shock, alo cardiogenic shock ene.
• Dɔgbo me ʋu ƒe sisi ƒe dɔléle .
• Alɔ̃madɔmadɔ kple ʋuʋudedi ɣeyiɣi didi.
• Aɖi si nye carbon monoxide ƒe aɖi.

Ƒomevi B

Lactic acidosis ƒomevi B dzɔna ne hypoxemia alo hypoxia mele eme o . Ƒomevi sue etɔ̃e li.

Ƒomevi B1

Dɔléle siwo le ete siwo doa kplamatse ŋutete si le ame si be wòatrɔ asi le lactate ŋu gbɔe esia tsona.

Woate ŋu anye:

• Aklãdɔléle .
• Ayikudɔléle .
• Thiamine (vitamin B1) ƒe anyimanɔmanɔ.
• Kansa.
• HIV/AIDS ƒe nɔnɔme.
• Mitochondrial dɔlélewo .
• Ketoacidosis si do ƒome kple suklidɔ .
• Ahanono ƒe numame ( Ahanono ƒe kuxi ).

Ƒomevi B2

Esia dzɔna abe atike kple aɖi aɖewo ƒe nugbegblẽ le ame ŋu ene. Kpɔɖeŋuwo:

• Cyanide ƒe aɖi.
• Aɖi si nye carbon monoxide ƒe aɖi.
• Aha sesẽ ƒe aɖi.
• Cocaine zazã.
• HIV dɔlékuiwutike aɖewo ( Nucleoside reverse transcriptase inhibitors (dɔlékuiwutikewo) ).
• Atike ƒomevi aɖewo siwo wozãna na dɔlélewo abe asrã ene ( Beta-adrenergic agonist inhalers ).
• Epinephrine dodo na nulɔdɔ sesẽwo.
• Dɔlékuiwutike si nye linezolid .
• Propofol na atike si wua alɔ̃dɔdɔ.
• Metformin, si nye atike si wozãna na suklidɔ (wozãa esia le Sri Lanka ŋutɔ, eyata ele be nànya esia vevietɔ).

Ƒomevi B3

Esia tsoa enzyme tɔxɛ siwo hiã be woatsɔ atrɔ asi le lactate ŋu ƒe anyimanɔmanɔ si wodzina gbɔ. Esiawo mebɔ kura o. Kpɔɖeŋuwo:

• Glycogen dzraɖoƒe ƒe dɔléle .
• Fructose-1,6-diphosphatase ƒe anyimanɔmanɔ .
• Pyruvate carboxylase ƒe anyimanɔmanɔ .
• Pyruvate dehydrogenase ƒe anyimanɔmanɔ .
• Oxidative phosphorylation ƒe anyimanɔmanɔ .
• Methylmalonic aciduria ƒe dɔléle .

D-lactic acidosis ƒe dɔléle

A kple B ƒomevi siwo ŋu míeƒo nu tsoe va yi la do ƒome kple L-lactate ƒe ƒuƒoƒo ɖe wò ʋu me. L-lactate sia nye lactic acid ƒomevi aɖe si wowɔna le amegbetɔ ƒe ŋutilã me eye wotrɔa asi le eŋu le dzɔdzɔme nu.

Gake lactic acidosis ƒomevi bubu aɖe hã li si mebɔ kura o, si tsoa D-lactate ƒe ƒuƒoƒo gbɔ. Dɔlékui ƒomevi aɖe si le wò dɔgbo gã me ye wɔa lactic acid sia. Wowɔa D-lactate abe nusi dona tso eme ene ne dɔlékui siawo trɔa asi le carbohydrates ŋu le nuɖuɖumeŋusẽ me.

D-lactic acidosis dzɔna ne dɔlékui siawo tsi akpa. Emegbe woxɔa D-lactate si sɔ gbɔ la tso dɔgboa me yia ʋua me. Míaƒe ayiku alo aklã mate ŋu atrɔ asi le D-lactate ŋu o. Eyata eyia edzi ƒoa ƒu ɖe ʋua me. Zi geɖe la, wobua esia be enye nɔnɔme aɖe si woyɔna be dɔgbo kpui ƒe dɔléle ƒe kuxi .

Aleke wokpɔa dɔléle si nye Lactic Acidosis?

Ðɔktawo nɔa te ɖe nusiwo gbɔna dzi kpɔae ɖa be lactic acidosis le ŋuwò hã:

• Lactate ƒe agbɔsɔsɔ le ʋu me wu 4 mmol/L (millimoles le lita ɖeka me).
• Ʋu ƒe pH mede 7.35 o.

Wodzidzea asixɔxɔ siawo to ʋu aɖe ɖeɖe le asiwò me eye wodoe kpɔ.

Dodokpɔ kawoe wowɔna na esia?

Wowɔa dodokpɔ siwo gbɔna tsɔ dea dzesi lactic acidosis :

• Comprehensive metabolic panel (CMP) : Esia nye ʋudodokpɔ bɔbɔe aɖe si dzidzea nu vovovo siwo le wò ʋu me be woakpɔ nyatakaka veviwo tso wò lãmesẽ ŋu.
• Ʋu me lactate dodokpɔ : Tsɔ kpe ɖe nusi wodzidzena le CMP me ŋu la, wodzidzea lactate ƒe agbɔsɔsɔ le wò ʋu me koŋ.
• Anion gap blood test : Dodokpɔ sia dzidzea wò ʋu ƒe pH kple elektrikŋusẽ ƒe dadasɔ.
• Ʋukawo me ʋu ƒe gas dodokpɔ : Esia dzidzea oxygen ƒe agbɔsɔsɔ si le wò ʋukawo me, kpakple pH kple elektrikŋusẽ ƒe dadasɔ.

Aleke wodaa Lactic Acidosis ƒe dɔléleae?

Ne lactic acidosis le ŋuwò le ɣeyiɣi kpui aɖe ƒe nusi gbɔ wòtso, abe kamedede fũ, ʋuʋu, alo alɔ̃madɔmadɔ ene ta la, zi geɖe la, nu ayi le ɣeyiɣi aɖe megbe. Àte ŋu akpɔ gbɔdzɔe ne ènɔ aƒeme eye tsi nɔa tsi me.

Gake le kɔdzi la, wotsɔa tsi siwo wodona ɖe ʋuka me ( IV fluids , that’s what we call saline) kple atike bubu siwo wotsɔ gagbɔa agbe ame, abe oxygen therapy ene, daa lactic acidosis enumake ne ehiã.

Emegbe woanɔ te ɖe nusi gbɔ wòtso dzi anya atikewɔwɔ. Le wò dzesiwo nu la, wò atikewɔlawo ƒe ƒuƒoƒoa awɔ dɔ atsɔ ada atikewɔwɔ ƒe nɔnɔme alo aɖi si le lactic acidosis la hem vɛ .

Ne èle oxygen ƒe agbɔsɔsɔ si bɔbɔ ƒe dzesiwo ɖem fia la, atikewɔlawo ƒe ƒuƒoƒoa asusui be Type A gbɔe wòtso – abe dzi alo gbɔgbɔtsixe ƒe dɔmawɔmawɔ nyuie, sepsis , alo dzidziƒoame ene – eye woawɔ atike na nɔnɔme kpata mawo gbã.

Le nɔnɔme siwo me womeɖee fia be oxygen ƒe agbɔsɔsɔ si le sue o me la, wobua nu vovovo siwo gbɔ ƒomevi B tsona ŋu eye wodaa wo koŋ.

Nuka ƒomevie ame si ŋu lactic acidosis le ate ŋu akpɔ mɔ be emetsonuwo ado tso eme?

Nusiwo dona tso eme nɔ te ɖe nusi gbɔ nɔnɔmea tso kple eƒe sesẽ dzi. Type A lactic acidosis – si do ƒome kple sepsis , dzidziƒoame, kple/alo oxygen ƒe tsɔtsɔ yi ʋu me dzi ɖeɖe kpɔtɔ – nye nusi nu sẽ wu. Lactic acidosis ƒomevi bubuwo ate ŋu anɔ bɔbɔe wu eye woadze egɔme blewu, si ana ɣeyiɣi kple mɔnukpɔkpɔ geɖe wu nasu ame si be woadae.

Le goawo katã me la, ne lactate ƒe agbɔsɔsɔ le ʋu me le dzidzim ɖe edzi la, ame siwo kuna ate ŋu adzi ɖe edzi. Gake woate ŋu ahaya bliboe ne wowɔ atike nɛ kaba eye wòwɔ dɔ nyuie.

Lactic acidosis nye nɔnɔme vovovo siwo woyɔna be metabolic acidosis, si me acid ƒoa ƒu ɖe wò ʋu me la dometɔ ɖeka. Le metabolic acidosis me la, ŋutilãa ƒe lãmenugbagbeviwo ƒe dɔwɔwɔ nyuie si wɔa acid hekpɔa edzi la gblẽna le mɔ aɖe nu. Zi geɖe la, wò aklã kple ayiku ate ŋu akɔ acid si sɔ gbɔ ɖe eme la ɖa. Gake ne ŋutinu mawo mele dɔ wɔm nyuie o la, womete ŋu kpɔa acidosis gbɔ boo o. Eyata beléle na wò aklã kple ayiku to tsi geɖe nono me, aha sesẽ dzi ɖeɖe kpɔtɔ kple atike siwo gblẽa nu le ame ŋu nono ate ŋu akpe ɖe ŋuwò ŋutɔ be nàlé wò lãmesẽ me ɖe asi ɣeyiɣi didi.

Nya kpui siwo dzi wòle be míaɖo ŋkui

Enyo, eyata mina míaɖo ŋku nu vevi aɖewo siwo ŋu míeƒo nu tsoe egbea dzi na wò:

• Lactic acidosis nye lactic acid ƒe dzidziɖedzi le ʋu me.
• Susu geɖewo ate ŋu anɔ esia ta. Susu vevitɔe nye be ŋutilãa mele oxygen si sɔ xɔm o.
• Dzesi gbãtɔwo ate ŋu anye ɖeɖiteameŋu si gbɔ eme, ʋuʋudedi, kple gbɔgbɔ kabakaba.
• Wowɔa ʋudodokpɔwo tsɔ dea dzesi dɔléle sia.
• Atikewɔwɔ nɔ te ɖe nusi gbɔ wòtso dzi. Ɣeaɖewoɣi la, ɖiɖiɖeme kple tsi sɔ gbɔ, ɣeaɖewoɣi la, ehiãna be woaxɔ ame ɖe kɔdzi.
• Ne wokpɔ dɔlélea dze sii hedae kaba la, woate ŋu adae.
• Aklã kple ayiku ƒe lãmesẽ me nɔnɔ kpena ɖe ame ŋu be woakpɔ ame ta tso nɔnɔme siawo tɔgbe me.

Eyata, ne dzesi siawo dometɔ aɖe le ŋuwò, alo ne èdi be yeanya nu geɖe tso esia ŋu la, mègaŋlɔ be be yeayi ɖɔkta gbɔ o. Nɔ lãmesẽ me!

` Lactic acidosis, lactic acidosis, lactate, ʋu ƒe acidity, ŋutilã me acid ƒe dadasɔ, kamedede, lãmesẽ