vi medicine informatics




In patients with sepsis, metabolismis increased overall due to multiple mechanisms, including high fever and inflammation. In the tissues, more CO2 is being produced because of the increased metabolic rate. Furthermore, due to sepsis; the infection leads to vasodilitation of the peripheral tissue which subsequently leads to less blood flow back to the tissue over time. This results in ischemia and eventually an acidic environment. The additional CO2 enters the RBCs, and carbonic anhydrase catalyzes a reaction with water to form carbonic acid (H2CO3), which then dissociates into H+ and HCO3-. The hydrogen ions are buffered by the deoxyhemoglobin, while the HCO3- diffuses out of the RBCs in exchange for Cl-. This is called the chloride shift.

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