The document discusses acid-base imbalances in the body. It explains that the body produces more acids than bases through foods, lipid and protein metabolism, and cellular metabolism producing carbon dioxide. The pH of the body is maintained through buffers, the lungs, kidneys, and production of new bases. Respiratory acidosis occurs when carbonic acid levels are too high due to high blood carbon dioxide levels. Respiratory alkalosis is caused by hyperventilation and low carbon dioxide levels. Metabolic acidosis is caused by bicarbonate deficit or acid accumulation, while metabolic alkalosis occurs due to bicarbonate excess. The document outlines the causes, symptoms, compensation mechanisms, and treatments for each type of acid-

1. ACID & BASE
IMBALANCE
BY: MUHAMMAD HALMII
FB: MUHAMMAD HELMI
WHATSAPP:0163626470
TWITTER:@CHALDEAPRINCE

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5. THE BODY PRODUCES MORE ACIDS
THAN BASES
• Acids take in with foods
• Acids produced by metabolism of lipids and proteins
• Cellular metabolism produces CO2.
• CO2 + H20 ↔ H2CO3 ↔ H+ + HCO3
-
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7. PH CHANGE DEFENDERS
• Buffers
• Chemical Resistors
• Lungs
• Excrete Acids (Volatile)
• Kidney
• Excrete Acids/Bases (Non-Volatile/Titratable)
• Produce NEW Bases
• Most Powerful But Slowest Response

12. Le Chatelier’s
Principle

15. COMPENSATION
• If underlying problem is metabolic, hyperventilation or
hypoventilation can help : respiratory compensation.
• If problem is respiratory, renal mechanisms can bring about
metabolic compensation.
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27. RESPIRATORY
ACIDOSIS

28. RESPIRATORY ACIDOSIS
• Carbonic acid excess caused by blood levels of CO2 above 45
mm Hg
• Hypoventilate
• Hypercapnia – high levels of CO2 accumulation in blood
• Never due to ↑ CO2 production {Metabolism is usually stable}
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32. COMPENSATION FOR RESPIRATORY
ACIDOSIS
• Kidneys eliminate hydrogen ion and retain bicarbonate ion
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33. SIGNS AND SYMPTOMS OF
RESPIRATORY ACIDOSIS
• Breathlessness
• Restlessness
• Lethargy and disorientation
• Tremors, convulsions, coma
• Respiratory rate rapid, then gradually depressed
• Skin warm and flushed due to vasodilation caused
by excess CO2 33

34. TREATMENT OF RESPIRATORY
ACIDOSIS
• Restore ventilation
• IV lactate solution
• Treat underlying dysfunction or disease
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35. RESPIRATORY ALKALOSIS

36. RESPIRATORY ALKALOSIS
• Hyperventilate
• Carbonic acid deficit
• pCO2 less than 35 mm Hg (hypocapnia)
• Most common acid-base imbalance
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37. RESPIRATORY ALKALOSIS
• Conditions that stimulate respiratory center:
• Oxygen deficiency at high altitudes
• Pulmonary disease and Congestive heart failure – caused
by hypoxia
• Acute anxiety
• Fever, anemia
• Early salicylate intoxication {Respi Stimulants}
• Cirrhosis
• Gram-negative sepsis
• Hysterical Breathing
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38. COMPENSATION OF RESPIRATORY
ALKALOSIS
• Kidneys conserve hydrogen ion
• Excrete bicarbonate ion
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39. SYMPTOMS OF RESPIRATORY
ALKALOSIS
• Dizziness
• Cramps Due To Hypocalcemia {Competes With H+
Binding With
Albumin}
• Tetany
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40. TREATMENT OF
RESPIRATORY ALKALOSIS
• Treat underlying cause
• Breathe into a paper bag
• IV Chloride containing solution –
Cl- ions replace lost bicarbonate ions
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41. METABOLIC ACIDOSIS
• Bicarbonate deficit
• Causes:
• Loss of bicarbonate through diarrhea or renal dysfunction {RTA}
• Accumulation of acids (lactic acid or ketones) (Non Volatile)
{MUDPILES}
• Failure of kidneys to excrete H+
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43. SYMPTOMS OF METABOLIC ACIDOSIS
• Headache, lethargy
• Nausea, vomiting, diarrhea
• Coma
• Death
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44. COMPENSATION FOR METABOLIC
ACIDOSIS
• Increased ventilation
• Renal excretion of hydrogen ions if possible
• K+ exchanges with excess H+ in ECF
• ( H+ into cells, K+ out of cells)
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45. TREATMENT OF METABOLIC ACIDOSIS
• IV lactate solution
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46. METABOLIC ALKALOSIS
• Bicarbonate excess
• Causes:
• Acid Loss = Excess vomiting ; Nasogastric Suction
• Excessive use of alkaline drugs
• HypoK {Transcelullar Shift}
• Excessive HCO3- Reabsorption {Hypraldosteronism}
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47. COMPENSATION FOR METABOLIC
ALKALOSIS
• Alkalosis most commonly occurs with renal dysfunction, so
can’t count on kidneys
• Respiratory compensation difficult – hypoventilation limited by
hypoxia
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48. SYMPTOMS OF METABOLIC ALKALOSIS
• Respiration slow and shallow
• Hyperactive reflexes ; tetany
• Often related to depletion of electrolytes
• Atrial tachycardia
• Dysrhythmias
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49. TREATMENT OF METABOLIC ALKALOSIS
• Electrolytes to replace those lost
• IV chloride containing solution
• Treat underlying disorder
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50. DIAGNOSIS OF ACID-BASE IMBALANCES
1. Note whether the pH is low (acidosis) or high (alkalosis)
2. Decide which value, pCO2 or HCO3
- , is outside the normal
range and could be the cause of the problem. If the cause is
a change in pCO2, the problem is respiratory. If the cause is
HCO3
- the problem is metabolic.
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