Concepts of acid base balance and its disorders are very important for practice of medicine.It is for the benefit of medical and students of allied fields.
Concepts of acid base balance and its disorders are very important for practice of medicine.It is for the benefit of medical and students of allied fields.
Short Review regarding Metabolic Acidosis
The Causes, anion gap,urine osmolal gap, Renal Tubular Acidosis, approach to Metabolic Acidosis in Final Slide
The body's balance between acidity and alkalinity is referred to as acid-base balance. The blood's acid-base balance is precisely controlled because even a minor deviation from the normal range can severely affect many organs. The body uses different mechanisms to control the blood's acid-base balance.
Short Review regarding Metabolic Acidosis
The Causes, anion gap,urine osmolal gap, Renal Tubular Acidosis, approach to Metabolic Acidosis in Final Slide
The body's balance between acidity and alkalinity is referred to as acid-base balance. The blood's acid-base balance is precisely controlled because even a minor deviation from the normal range can severely affect many organs. The body uses different mechanisms to control the blood's acid-base balance.
essential details on maintenance of extracellular fluid pH, Especially Blood for normal physiological function of the body and condition associated wit acid base imbalance
The state of equilibrium between proton donors and proton acceptors in the buffering system of the blood that is maintained at approximately pH 7.35 to 7.45 under normal conditions in arterial blood.
The state of equilibrium between proton donors and proton acceptors in the buffering system of the blood that is maintained at approximately pH 7.35 to 7.45 under normal conditions in arterial blood.
Buffer is any mechanism that resists changes in pH by converting a strong acid or base to a weak one.
A review of ACID AND BASE: What's Acid and Base? what are the normal range and how the body can regulate? finally what will happen if there is error in maintaining acid base balance system
THIS PRESENTATION WILL COVER THE FOLLOWING AREAS
Definitions
Buffer systems
Regulatory systems
Anion Gap and Osmolar gap
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Buffer-It is a solution of weak acid/base & it’s corresponding salt which resists a change in pH when a small amount of acid or base is added to it.
By buffering mechanism, a strong acid (or base) is replaced by a weaker one.
pH, quantitative measure of the acidity or basicity of aqueous or other liquid solutions
Blood buffer- 1. A chemical buffer is a system of one or two molecules that acts to resist changes in pH by binding H+ when the pH drops, or releasing H* when the pH rises.
2. The bicarbonate buffer system is the main buffer of the extracellular fluid, and consists of carbonic acid and its salt, sodium bicarbonate.
H2CO3+NaHCO3
a. When a strong acid is added to the solution, carbonic acid is mostly unchanged, but bicarbonate ions of the salt bind excess H+, forming more carbonic acid.
b. When a strong base is added to solution, the sodium bicarbonate remains relatively unaffected, but carbonic acid dissociates further, donating more H+ to bind the excess hydroxide.
c. Bicarbonate concentration of the extracellular fluid is closely regulated by the kidneys, and plasma bicarbonate concentrations are controlled by the respiratory system.
3. The phosphate buffer system operates in the urine and intracellular fluid similar to the bicarbonate buffer system: sodium dihydrogen phosphate (NaH,PO) is its weak acid, and monohydrogen phosphate (Na,HPO,) is its weak base.
4. The protein buffer system consists of organic acids containing carboxyl groups that dissociate to release H+ when the pH begins to rise, or bind excess H+ when the pH declines.
Respiratory regulation of PH-The lungs have the ability to exhale CO, which is the substrate for H2CO3 and HCO3.
Thus, by regulating the rate of pulmonary ventilation through chemoreceptors, PCO, is regulated by lungs.
So, a high PCO, leads to decrease in pH and low PCO, increase in pH.
High PCO, stimulates ventilation which results in removal of CO₂ by expiration.
Renal Mechanisms of Acid-Base Balance- 1. Only the kidneys can rid the body of acids generated by cellular metabolism, while also regulating blood levels of alkaline substances and renewing chemical buffer components.
a. Bicarbonate ions can be conserved from filtrate when depleted, and their reabsorption is dependent on H+ secretion
Conservation of Bicarbonate lons
b. Type A intercalated cells of the renal tubules can synthesize new bicarbonate ions while excreting more hydrogen ions.
Synthesis of New Bicarbonate/Excretion of BufferedH*
c. Ammonums are weak acids that are excreted and urine, replenishing the alkaline reserve of the blood.
NH4+, Excretion
d. When the body is in alkalosis, type B intercalated cells excrete bicarbonate, and reclaim hydrogen ions.
Acid base disorder-1. When arterial blood pH rises above 7.45, the body is in alkalosis; when arterial pH falls below 7.35, the body is in acidosis.
2. Most hydrogen ions originate as metabolic by-products, although they can also enter the body via ingested foods.
Metabolic acidosis:
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1. METABOLIC ACIDOSIS :
IN METABOLIC ACIDOSIS, THE SYSTEMIC ARTERIAL
BLOOD HCO3 LEVEL DROPS BELOW 22 MEQ/L.
CAUSES OF LOWER THE BLOOD LEVEL OF HCO3 ARE :
1. ACTUAL LOSS OF HCO3 IONS.
2. ACCUMULATION OF AN ACID OTHER THAN CARBONIC
ACID, AS MAY OCCUR IN KETOSIS.
3. FAILURE OF KIDNEYS TO EXCRETE H+ IONS
IF THE PROBLEM IS NOT TO SEVERE
HYPERVENTILATION CAN HELP BRING BLOOD PH INTO
NORMAL RANGE.
TREATMENT INCLUDES THE ADMINISTERING
INTRAVENOUS SOLUTION SODIUM BICARBONATE AND
CORRECTING THE CAUSE OF THE DISEASE.
2. METABOLIC ALKALOSIS :
In metabolic alkalosis , the systemic arterial blood HCO3,
concentration is above 26 mEq/L.
Causes :
• A nonrespiratory loss of acid or excessive intake of alkaline drugs
results in rise in pH of blood.
• Excessive vomiting which results in the substantial loss of HCL.
• Gastric suctioning, use of diuretics, and severe dehydration.
Treatment :
1.Respiratory compensation through hypoventilation.
2.Giving fluid solutions to correct Cl, K ion & other electrolyte
deficiencies plus correcting the cause of alkalosis.
4. ROLE OF KIDNEYS IN ACID – BASE IMBALANCE:
Proximal convoluted tubule and
collecting ducts –
• Cells of both PCT and collecting
ducts of kidneys secretes H+ ions in
the tubular fluid.
• In the PCT Na+/H+ antiporters
secrete H+ as they absorb Na+.
5.
6. • INTERCALATED CELLS OF COLLECTING DUCTS :
• The apical membrane of some intercalated cells includes proton pumps [H+ ATPase] that secretes H ions
into tubular fluid. They can make urine 3 pH units more acidic than blood.
• HCO3- , produced by dissociation of H2CO3 inside IC crosses the basolateral membrane by means of Cl-
/HCO3- antiporters which diffuses into peritubular capillaries.
• 2ND type of intercalated cell has proton pump in its basolateral membrane and Cl/HCO3 antiporters in its
apical membrane. They secrete HCO3- and reabsorb H+.
7.
8. BUFFERING OF H+ IONS IN URINE :
Two other buffers combine with H+ in the collecting duct.
The most plentiful buffer in the tubular fluid of the collecting duct is HPO4, small amount of NH3 is also
present.
H+ combines with HPO4 to form H2PO4 and with NH3 to form NH4+.
These ions are excreted in the urine.
