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Acid-base balance.pptx

Acid-base balance.pptx

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LECTURE 2:
ACID-BASE BALANCE
Course: Clinical Biochemistry I
1
Course outlines
• Buffer system
• Metabolic acidosis and alkalosis
• Respiratory acidosis and alkalosis
• Blood gases
Monday, 20 February 2023 2
Acid and base
Monday, 20 February 2023 3
 Acids are H+ donors.
• Bases are H+ acceptors or give up OH- in solution.
• Acids and bases can be:
• Strong – dissociate completely in solution
• Ex: strong acids such as HCl
strong Bases as NaOH
• Weak – dissociate only partially in solution
• Lactic acid, carbonic acid
PH of the human body
• The body's balance between acidity and alkalinity is
referred to as acid-base balance or acid-base homeostasis.
• Homeostasis: the body's ability to physiologically regulate
its inner environment to ensure its stability in response to
fluctuations in the outside environment.
• Body PH ranged from 7.35-7.45, any change in blood PH is
critical because it affects protein and enzyme stability and
function.
Monday, 20 February 2023 4
Monday, 20 February 2023 5
Acid production in the body
• Human body produces acids more than bases.
• Acids are taken in with foods.
• Also, acids are produced by the metabolism of lipids and
proteins.
• Cellular metabolism produces CO2.
CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3
-
Monday, 20 February 2023 6

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Acid-base balance.pptx

  • 1. LECTURE 2: ACID-BASE BALANCE Course: Clinical Biochemistry I 1
  • 2. Course outlines • Buffer system • Metabolic acidosis and alkalosis • Respiratory acidosis and alkalosis • Blood gases Monday, 20 February 2023 2
  • 3. Acid and base Monday, 20 February 2023 3  Acids are H+ donors. • Bases are H+ acceptors or give up OH- in solution. • Acids and bases can be: • Strong – dissociate completely in solution • Ex: strong acids such as HCl strong Bases as NaOH • Weak – dissociate only partially in solution • Lactic acid, carbonic acid
  • 4. PH of the human body • The body's balance between acidity and alkalinity is referred to as acid-base balance or acid-base homeostasis. • Homeostasis: the body's ability to physiologically regulate its inner environment to ensure its stability in response to fluctuations in the outside environment. • Body PH ranged from 7.35-7.45, any change in blood PH is critical because it affects protein and enzyme stability and function. Monday, 20 February 2023 4
  • 6. Acid production in the body • Human body produces acids more than bases. • Acids are taken in with foods. • Also, acids are produced by the metabolism of lipids and proteins. • Cellular metabolism produces CO2. CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3 - Monday, 20 February 2023 6
  • 7. Body control against small change in PH Monday, 20 February 2023 7 The body regulates its PH through two systems: A) Chemical buffer systems: 1. Bicarbonate buffer system. 2. Phosphate buffer system. 3. Protein buffer system. B) Physiological buffer systems: 1. Respiratory mechanism. 2. Renal (Kidney excretion) mechanism. • Body response to acid-base imbalance is called compensation. • It may be complete if brought back within normal limits, while If the range is still outside normal it will be partial.
  • 8. Bicarbonate buffer • It is the main extracellular buffer and plays an important role in maintaining the pH homeostasis of the blood. • Carbonic acid (H2CO3, weak acid) dissociates reversibly and releases bicarbonate ions (HCO3 –, , weak base) and protons (H+) as follows: 1. Response to an increase in pH (H+ proton donor) H2CO3 -> HCO3– + H+ 2. Response to a decrease in pH (H+ proton acceptor) H2CO3 <- HCO3– + H+ 3. Under normal conditions, the ratio between the HCO3– and H2CO3 in the blood is 20:1 (HCO3– : H2CO3) Monday, 20 February 2023 8
  • 10. Phosphate Buffer • It is the major intracellular buffer. • It consists of dihydrogen phosphate ions (H2PO4 -) as hydrogen-ion donors (acid) and hydrogen phosphate ions (HPO4 2-) as hydrogen-ion acceptors (base). • These two ions are in equilibrium with each other as indicated by the chemical equation below: Monday, 20 February 2023 10
  • 11. Protein buffer • It includes hemoglobin, work in blood, and intracellular fluid (ISF) (i.e. plasma proteins). • Carboxyl group gives up H+ • Amino Group accepts H+ • Side chains that can buffer H+ are present on 27 amino acids. Monday, 20 February 2023 11
  • 13. Respiratory buffer mechanism Monday, 20 February 2023 13 • Respiratory system does not respond as fast as the chemical buffer systems. • Powerful, but only works with volatile acids. • Doesn’t affect fixed acids like lactic acid. • CO2 produced by the tissue cells enters the red blood cells and is converted to HCO3 – ions as follows: CO2 + H2O↔ H2CO3 ↔ H+ + HCO3 - • Body pH can be adjusted by changing the rate and depth of breathing.
  • 15. Renal buffer mechanism • It can eliminate large amounts of acid and also excrete base. • Can conserve and produce bicarb ions. • Most effective regulator of pH • If kidneys fail, pH balance fails. Monday, 20 February 2023 15
  • 17. Rate of PH correction Monday, 20 February 2023 17
  • 18. Metabolic acidosis • It occurs due to a decrease blood bicarbonate level, either due to increased H production or depletion of bicarbonate. • Usually, associated with hyperkalemia due to sodium reabsorption with excess H excretion. • Causes of increase in H ions production: 1- Diabetic ketoacidosis. 2- Lactic acidosis. 3- Poisoning • Causes of bicarbonate depletion: 1- Loss of bicarbonate through GIT as diarrhea. 2- Renal tubular acidosis. • Compensatory mechanism: the respiratory mechanism through hyperventilation Monday, 20 February 2023 18
  • 20. Metabolic alkalosis • It occurs due to an increased bicarbonate level. • It is less serious than metabolic acidosis because bicarbonate production is slower than H production. • Usually, associated with hypokalemia due to increased sodium reabsorption with potassium excretion in the renal tubule. • Causes: 1. GIT loss of H through vomiting or use of antacids. 2. Renal loss of H as in diuretic therapy. 3. Mineralocorticoid excess. 4. Cashing`s syndrome. Compensatory mechanism: the respiratory mechanism through hypoventilation Monday, 20 February 2023 20
  • 22. Respiratory acidosis • It occurs due to the accumulation of PCO2 in the blood. • Causes: 1. Chronic lung diseases. 2. Bronchial obstruction. 3. CNS depression. • Compensatory mechanism: increase bicarbonate reabsorption in the kidney. Monday, 20 February 2023 22
  • 24. Respiratory alkalosis • It occurs due to a decrease in PCO2 in the blood. • Causes: 1. Hypoxia. 2. CNS disorders. 3. Pregnancy. • Compensatory mechanism: increase bicarbonate excretion through the kidney. Monday, 20 February 2023 24
  • 27. Estimation of blood PH and gases • Measurement of blood gases requires the collection of arterial blood in a specific syringe containing heparin. • Put in ice immediately and no need for fasting. • Blood gases analyzer used for estimation of partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), and PH. • Then both the anion gap and bicarbonate were calculated by the machine. Monday, 20 February 2023 27