当直医のスレ Part 32

当直医のスレ Part 32at HOSP

当直医のスレ Part 32 - 暇つぶし2ch■コピペモード
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250:卵の名無しさん
 23/07/20 18:37:54.75 Mz3Ba9iA.net
Astrap <- \(pH,pCO2,HCO3){ 
e=1e-12 
pH_l=7.36-e 
pH_u=7.44+e 
pCO2_l=36-e 
pCO2_u=44+e 
HCO3_l=22-e 
HCO3_u=26+e 
expected_CO2=NULL 
expected_HCO3=NULL 
status=NULL 
HH =\(pCO2,HCO3,pK=6.1) round(pK+log10(HCO3/(pCO2*0.03)),2) # Henderson-Hasselbalch 
if(pH_l<pH & pH<pH_u){ 
if(pCO2>pCO2_u){ 
primary="mixed respiratory acidosis" 
additional="and metabolic alkalosis" 
} 
if(pCO2<pCO2_l){ 
primary="mixed respiratory alkalosis" 
additional="and metabolic acidosis" 
} 
} 
if(pCO2_l<pCO2 & pCO2<pCO2_u){ 
if(pH>pH_u){ 
primary="mixed metaboic alkalosis" 
additional="and respiratory acidosis" 
} 
if(pH<pH_l){ 
primary="mixed metabolic acidosis" 
additional="and respiratory alkalosis" 
} 
}

251:卵の名無しさん
 23/07/20 18:38:17.30 Mz3Ba9iA.net
if(pH<pH_l & pCO2<pCO2_l){ 
primary="primary metabolic acidosis" 
expected_pCO2=40 + 1.2*(HCO3-24) 
if(pCO2<expected_pCO2) additional= "secondary respiratory alkalosis" 
if(pCO2>expected_pCO2) additional= "secondary respiratory acidosis" 
expected_pH=HH(expected_pCO2,HCO3) 
} 
if(pH>pH_u & pCO2>pCO2_u){ 
primary="primary metabolic alkalosis" 
expected_pCO2=40 + 0.7*(HCO3-24) 
if(pCO2<expected_pCO2) additional= "secondary respiratory alkalosis" 
if(pCO2>expected_pCO2) additional= "secondary respiratory acidosis" 
expected_pH=HH(expected_pCO2,HCO3) 
} 
if(pH<pH_l & pCO2>pCO2_u){ 
primary="primary respiratory aciosis" 
if(HCO3_l<HCO3 & HCO3<HCO3_u) status="acute" else status="chronic" 
if(status=="acute") expected_HCO3=24+0.1*(pCO2-40) 
if(status=="chronic") expected_HCO3=24+0.4*(pCO2-40) 
if(HCO3<expected_HCO3) additional="incomplete renal response" 
if(HCO3>expected_HCO3) additional="secondary metabolic alkalosis" 
expected_pH=HH(pCO2,expected_HCO3) 
} 
if(pH>pH_u & pCO2<pCO2_l){ 
primary="primary respiratory alkalosis" 
if(HCO3_l<HCO3 & HCO3<HCO3_u) status="acute" else status="chronic" 
if(status=="acute") expected_HCO3=24+0.2*(pCO2-40) 
if(status=="chronic") expected_HCO3=24+0.4*(pCO2-40) 
if(HCO3<expected_HCO3) additional="secondary metabolic acidosis" 
if(HCO3>expected_HCO3) additional="incomplete renal response" 
expected_pH=HH(pCO2,expected_HCO3) 
} 
cat(status,primary,'\n') 
cat(additional,'\n\n') 
if(!is.null(expected_CO2)|!is.null(expected_HCO3)){ 
return(c(expected_CO2=expected_CO2,expected_HCO3=expected_HCO3,expected_pH=expected_pH)) 
} 
}

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