Eng / Emergency situation
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Waterhouse-Friderichsen syndrome
The adrenal glands almost completely stop producing hormones, which leads to disruption of all types of metabolism.
First of all, there is a sharp dehydration of the body and
the volume of circulating blood decreases.
Violation of potassium metabolism leads to the fact that the heart muscle begins to contract worse.
At the same time, carbohydrate metabolism suffers: blood sugar levels decrease,
increases the sensitivity of cells to insulin.
The work of the kidneys is disrupted.
Symptoms of acute adrenal insufficiency
a sharp drop in blood pressure which manifests itself in abundant sweat
cold hands and feet,
sudden weakness
the work of the heart is disturbed, arrhythmia develops;
nausea and vomiting, severe pain in the abdomen, diarrhea appear;
urine output decreases sharply (oligoanuria);
consciousness is disturbed.
At first, the patient is lethargic, speaks with difficulty, his voice is quiet, indistinct. Then there are hallucinations, fainting, coma occurs.
For the diagnosis of acute adrenal insufficiency
General blood analysis:
there is an increase in the number of red blood cells (erythrocytosis) and hemoglobin (due to blood clotting),
increase in the number of leukocytes and ESR;
Blood test for sugar: hypoglycemia (decrease in sugar levels);
Blood chemistry:
there is an increase in the level of potassium and creatinine, decrease in the level of sodium, chlorides;
General urine analysis:
protein, erythrocytes, sometimes acetone is determined;
Examination of the level of adrenal hormones in urine and blood: a sharp decrease in the amount of corticosteroids (cortisol, aldosterone, etc.) is detected;
ECG: signs of hyperkalemia
Acute respiratory failure
Acute respiratory failure
a set of pathological symptoms (symptom complex) that develop with a sharp decrease in the level of oxygen in the blood.
This is a life-threatening condition that, without proper care, is fatal within a maximum of a few hours.
PATHOGENESIS OF ARF
Due to the development of oxygen starvation of the body as a result of violations
alveolar ventilation,
diffusion of gases across the alveolar membranes and
uniform distribution of oxygen in organs and systems
Pathogenetic classification of ARF
ventilation
The defeat of the respiratory center of any etiology
Chest injury
Violation of the transmission of impulses in the neuromuscular apparatus
Parenchymal
Obstruction,
restriction,
airway constriction
Impaired diffusion of gases and blood flow in the lungs
Types of hypoxia:
1. Associated with a decrease in the partial oxygen content in the inhaled air (in high mountainous areas)
2. In pathological processes that disrupt the supply of oxygen to tissues at its normal content in the inhaled air:
Respiratory-alveolar hypoventilation
Circulatory - against the background of acute or chronic circulatory failure
Tissue - a violation of the processes of oxygen uptake at the tissue level (poisoning)
Hemic - a decrease in erythrocyte mass or a decrease in hemoglobin in erythrocytes
The main clinical syndromes of ARF
Hypoxia is a condition that develops with reduced tissue oxygenation.
Hypoxemia - a violation of the processes of oxygenation of arterial blood in the lungs
Hypercapnia is a pathological syndrome characterized by an increased level of carbon dioxide in the blood or at the end of expiration in the exhaled air.
Symptoms of hypercapnia (Pa CO2 is greater than 45 mm Hg):
The result of both increased activity of the sympathetic nervous system and the direct action of excess CO2 on tissues
From the side of the central nervous system:
flapping tremor
Insomnia
Frequent awakenings at night and sleepiness during the day
morning headaches nausea