hyperkalemia
abnormallyhighpotassiumconcentrationintheblood（aboveL）,mostoftenduetodefectiverenalexcretion,asinkidneydisease,severeandextensiveburns,intestinalobstruction,diabetesmellitus,acuterenalfailureandhypoadrenocorticism.
metabolicacidosis
DecreasedpH（belowandbicarbonateconcentrationofthebodyfluidscausedeitherbytheaccumulationofexcessacidsstrongerthancarbonicacidorbyabnormallossesofbicarbonatefromthebody.
metabolicalkalosis
Anincreaseinthealkalinityofbodyfluidsduetoanincreaseinalkaliintakeoradecreaseinacidconcentration,asfromvomiting.pHisover.
respiratoryacidosis
Acidosisthatiscausedbyretentionofcarbondioxide,duetoinadequatepulmonaryventilationorhypoventilation,andthatresultsinadecreaseinbloodpHunlesscompensatedforbyrenalretentionofbicarbonate.
respiratoryalkalosis
anabnormalconditioncharacterizedbyahighplasmapH（overresultingfromincreasedalveolarventilation.Theconsequentaccelerationofcarbondioxideexcretionlowerstheplasmalevelofcarbonicacid,thusraisingplasmapH.Thehyperventilationmaybecausedbypulmonaryandnonpulmonaryproblems.Somepulmonarycausesareacuteasthma,pulmonaryvasculardisease,andpneumonia.Somenonpulmonarycausesareaspirintoxicity,anxiety,feveretc.
acepsis
theexclusionofallmicroorganismsbeforetheycanenteranopensurgicalwoundorcontaminateasterilefieldduringsurgery
sterilization
theprocessofdestroyingallmicroorganismsandtheirpathogenicproducts.Itisaccomplishedbyheat（wetsteamordryheat）orbybactericidalchemicalcompounds.
disinfection
Theprocessoractofdestroyingpathogenicmicroorganisms.However,certainbacterialsporesmaysurviveandgerminatewhichcouldleadtocontamination.
bloodtransfusion
theadministrationofwholebloodoracomponent,suchaspackedredcells,toreplacebloodlostthroughtrauma,surgery,ordisease,inordertosupplementbloodvolume,improvecirculatoryfunctionandoxygen-carryingability,increasetheplasmaproteinandenhanceimmunityandcoagulationfunction.
hematocritHCT
ameasureofthepackedcellvolumeofredcells,expressedasapercentageofthetotalbloodvolume.Thenormalrangeisbetween43%and49%inmenandbetween37%and43%inwomen.
tansfusionreaction
agroupofclinicalsignsduetoantibodyintherecipient'sbloodreactingwiththetransfusedredbloodcellswhenbloodfortransfusionisincorrectlymatched,orwhentherecipienthasanadversereactiontosomeelementofthedonorblood.
SIRS
aninflammatorystateaffectingthewholebody,frequentlyaresponseoftheimmunesystemtoinfection,butnotnecessarilyso.Itisrelatedtosepsis,aconditioninwhichindividualsbothmeetcriteriaforSIRSandhaveaknownorhighlysuspectedinfection.
Temperature<36oCor>38oC
Heartrate>90beats/min
RespiratoryratepCO2<32mmHgor>20breaths/min
WBCcount<4x109or>12x109or,orthepresenceof>immatureneutrophils
transfusion-relatedacutelunginjuryTRALI
asyndromeseeninpersonsreceivingtransfusions,characterizedbypulmonaryedema,dyspnea,hypoxemia,hypotension,andfever;itisthoughttobeareactiontoantibodiesorothercomponentsofthedonorbloodproduct.Patientsneedoxygensupport,andinsomecasesthesyndromecanbefatal.
transfusionassociatedgraftversushostdisease
isararecomplicationofbloodtransfusion,inwhichthedonorTlymphocytesmountanimmuneresponseagainsttherecipient'slymphoidtissue.Donorlymphocytesareusuallyidentifiedasforeignanddestroyedbytherecipient'simmunesystem.However,insituationswheretherecipientisimmunocompromised,orwhenthedonorishomozygousandtherecipientisheterozygousforanHLAhaplotype,therecipient'simmunesystemisnotabletodestroythedonorlymphocytes.Thiscanresultingraftversushostdisease.
autologousbloodtransfusion/autotransfusion
Infusionofbloodorbloodproductsintotheindividualfromwhomtheywereoriginallywithdrawn.
freshfrozenplasmaFFP
anunconcentratedformofbloodplasmacontainingalloftheclottingfactorsexceptplatelets.Itcanbeusedtosupplementredbloodcellswhenwholebloodisnotavailableforexchangetransfusionortocorrectableedingproblemofunknowncause.Itisalsousedtocorrectdisseminatedintravascularcoagulation.
freshplasmaFP
aformofbloodplasmawhichisobtainedafterFFPismeltedat4℃andcryoprecipitateisremoved.
cryoprecipitateCryo
Aproductderivedfromaunitofwholeblood,whichhasavolumeof15mlandprovides80unitsoffactorVIII:
Cprocoagulant–forhemophiliaA,factorVIII:
vWF–vonWillebrand'sdisease,factorXIII,fibronectin,fibrinogen–forDIC,dysfibrinogenemia异样纤维蛋白原血症.ItistheunmeltedelementofFFPunder4℃.
plasmasubstitute/plasmavolumeexpander
asubstancethatcanbetransfusedtomaintainfluidvolumeofthebloodineventofgreatnecessity,supplementaltotheuseofwholebloodandplasma.Calledalsoartificialplasmaextender.
shock
Shockisamedicalemergencyinwhichtheorgansandtissuesofthebodyarenotreceivinganadequateflowofblood.Thisdeprivestheorgansandtissuesofoxygen（carriedintheblood）andallowsthebuildupofwastefactorsincludehemorrhage,vomiting,diarrhea,inadequatefluidintake,orexcessivefluidloss,resultinginhypovolemia.Shockcanresultinseriousdamageorevendeath.
hypovolemicshock
Thisisacommontypethathappenswhenbloodorplasmaislostinsuchquantitiesthattheremainingbloodcannotfillthecirculatorysystemdespiteconstrictionofthebloodvessels.Thebloodlossmaybeexternal,aswhenavesselisseveredbyaninjury,orthebloodmaybe“lost”intospacesinsidethebodywhereitisnolongeraccessibletothecirculatorysystem,asinseveregastrointestinalbleedingfromulcers,fracturesoflargeboneswithhemorrhageintosurroundingtissues,ormajorburnsthatattractlargequantitiesofbloodfluidstotheburnsiteoutsidebloodvesselsandcapillaries.
hemorrhagicshock
Hypovolemicshockresultingfromacutehemorrhageandcharacterizedbyhypotension,tachycardia心动过速,oliguria少尿,andbypale,cold,andclammyskin.
traumaticshock
referstoshockfollowingphysicaltrauma,withhemorrhage,peripheralbloodvesseldilation,andchangesincapillarypermeability.
septicshock
shockassociatedwithoverwhelminginfection,usuallybygram-negativebacteria,althoughitmaybeproducedbyotherbacteria,viruses,fungi,andprotozoa.Itisthoughttoresultfromtheactionofendotoxinsorotherproductsoftheinfectiousagent.
warmshock
referringtoastageinearlysepticshock,whichischaracterisedbyincreasedcardiacoutput,arterialandarteriolar小动脉的dilatation扩张,decreasedperipheralarterialresistance阻力,increasedperipheralperfusion灌注,nofluidlossesandthirdspacingandminimalcatecholamine儿茶酚胺effect
coldshock
MODS
thepresenceofalteredorganfunctioninacutelyillpatientssuchthathomeostasiscannotbemaintainedwithoutintervention.Itusuallyinvolvestwoormoreorgansystems.
CVP
thepressureofbloodintherightatrium.MeasurementofcentralvenouspressureismadepossiblebytheinsertionofacatheterthroughthemediancubitalveintothesuperiorvenanormalrangeforCVPis0to5mmH2O.Areadingof15to20mmusuallyindicatesinabilityoftherightatriumtoaccommodatethecurrentbloodvolume
PCWP
Anindirectindicationofleftatrialpressureobtainedbywedgingacatheterintoasmallpulmonaryarterytightlyenoughtoblockflowfrombehindandthustosamplethepressurebeyond.
COcardiacoutput
theeffectivevolumeofbloodexpelledbyeitherventricleoftheheartperunitoftime（usuallyperminute）.Itisequaltothestrokevolumemultipliedbytheheartrate.Normalvaluesare4to6litersperminute.
CIcardiacindex
cardiacoutputperunittimedividedbybodysurfacenormalrangeinahealthyadultisto3.5L/min/m2.
CAIS
acomplexpatternofimmunologicresponsestosevereinfectionorinjury.CARSisaglobaldeactivationoftheimmunesystemtaskedwithrestoringhomeostasis.
ARFacuterenalfailure
renalfailureofsuddenonset,suchasfromphysicaltrauma,infection,inflammation,ortoxicity.Symptomsincludeuremiaandusuallyoliguriaoranuria,withhyperkalemiaandpulmonaryedema.Threetypesaredistinguished:
prerenal,intrarenal,andpostrenal.
ARDSacuterespiratoryditresssyndro
升级会员 