LUNG BUFFER ACTIVITY IN SEPSIS COMPLICATED BY ORGAN DYSFUNCTION
Abstract
Aim. To study the acid-base balance (ABB) indices in various vascular beds and the buffering activity of the lungs in sepsis against the background of organ dysfunctions depending on the dominant organ damage and the severity of the condition. Material and methods. The article presents the results of comprehensive diagnostics and treatment of 100 patients with sepsis and organ and systemic dysfunctions, including group 1 (40 patients) with predominant acute kidney injury (AKI), group 2 (30 patients) with leading manifestations of acute liver failure (ALF), group 3 (30 patients) with dominant course of acute respiratory distress syndrome (ARDS), conditionally divided into subgroups depending on the functional state of metabolic functions of the lungs (MFL) (compensation, sub- and decompensation), and a control group of 30 practically healthy donors (PHD). pH, HCO3- and BE were studied from various vascular accesses (venous cubital blood, mixed venous blood and arterial blood), a comparative analysis of these parameters in arterial and mixed venous blood was performed. Results. Blood acid-base balance values, taken from various vascular beds, significantly differed depending on the stage of metabolic dysfunction. Gradual changes were observed, from compensated to decompensated metabolic acidosis. The lungs demonstrated an active buffering function, facilitating the correction of acid-base imbalances; however, the effectiveness of this mechanism decreased as the functional state of the metabolic dysfunction worsened. Conclusion. In case of organ dysfunctions against the background of sepsis, correction of acidosis with sodium bicarbonate should be carried out only taking into account the data of the B-A difference in pH, HCO3- and BE indicators of arterial blood. Key words: lung buffering function, metabolic lung function, acid-base balance, metabolic acidosis, metabolic alkalosis, blood buffering system, lungs, organ dysfunction, postpartum complications