pH = log [H+]

H+ is really a proton

Range is from 0 - 14

If [H+] is high, the solution is acidic; pH < 7

If [H+] is low, the solution is basic or alkaline

; pH > 7

2
3
 Mostenzymes function only with narrow pH
ranges
Acid-basebalance can also affect
electrolytes (Na+, K+, Cl-)
Can also affect hormones

4
 Acids taken in with foods
Acidsproduced by metabolism of lipids and
proteins
Cellular metabolism produces CO2.
CO2 + H20 H2CO3 H+ + HCO3-

5
 Buffer Solutions resist a change in pH

Buffers
contain relatively large
concentrations of either
An acid, HA and its conjugate base A-
A base, B, and its conjugate acid (BH+)
 pH = pK + log [Base]
[Acid]

Buffer Capacity amount of acid or base

required to change the pH by one unit
 Bicarbonate/carbonic acid buffer system

Phosphate buffer system

Plasma protein buffer system

Hemoglobin buffer system

 [HCO3-]
pH =pK +log
[H2CO3]

Most important buffer system

pK=6.1
Ratio of base to acid 20:1
Lungs can readily dispose or retain CO2
Renal tubules can increase or decrease the
rate of bicarbonate reclamation.
 [HPO42-]
pH =pK +log
[H2PO4-]
pK = 6.8
5% of non-bicarbonate buffer value of plasma
The phosphate buffer is important in the tubular
fluids of the kidney for two reasons
Phosphate concentrated in the tubules
The tubular fluid has lower pH than the extracellular fluid
does bringing the operating range of the buffer closer to
the pK (6.8) of the system
Important in buffering intracellular fluid
because the concentration of phosphate in this
fluid is many times that in the extracellular
fluid
 Albumin 95% of non-bicarbonate buffer value

Imidazole group of histidine (pK=6)

 CELL PLASMA ERYTHROCYTE

O2 O2 O2
Internal
HHbCO2 HHb
respiration
HbO2

PrCO2 dCO2 dCO2

CO2 CO2 CO2 + H2O H+ + HCO3

metabolism H2O

H+ HCO3

Cl- K+
protein

H-protein
+HCO3

HCO3
+
Cl- + Na+
 Hydrogen ion excretion

Renal production of ammonia and excretion

of ammonium ions

Reclamation of bicarbonate
 Reclamation of bicarbonate

Interstitial fluid Tubular cell Lumen

And plasma
Na+ HCO3-
Na+ Na+
HCO3- HCO3- H+

HHCO3
HHCO3

CA

CO2 CO2 CO2 +H2O

Interstitial fluid Tubular cell Lumen
And plasma
CO2 +H2O

CA
HHCO3

HCO3- HCO3- H+ H+

Na+ Na+ Na+ Na+ HPO42-

Na+ H2PO42-
Glutamine

NH4+ NH3
H+A-
Glutamate
NH4+ NH3 NH4+A-
-ketoglutarate

Urine
 Metabolic Acidosis

Metabolic Alkalosis

Respiratory Acidosis

Respiratory Alkalosis
20
 Bicarbonate deficit - blood concentrations of
bicarb drop below 22mEq/L
Causes:
Production of Acids (Ketoacidosis)
Reduced excretion of acids (RTA)
Excessive loss of bicarbonate.
Anion Gap
Na+ - [Cl- + HCO3-] = 12 mmol/L

21
 Respiratory mechanism
[HCO3-]
pH =pK +log
[0.23 X pCO2]

Renal Mechanism
Increased Na+H- exchange
Increased formation of ammonia
Increased reclamation of bicarbonate

22
 Bicarbonate excess - concentration in
blood is greater than 26 mEq/L
Causes:
Excess vomiting = loss of stomach acid
Excessive use of alkaline drugs
Certain diuretics
Endocrine disorders
Heavy ingestion of antacids

23
 Respiratory compensation
Retention ofCO2
[HCO3-]
pH =pK +log
[0.23 XpCO2]

Renal compensatory mechanism

Decreased Na+H- exchange
Decreased formation of ammonia
Decreased reclamation of bicarbonate

24
 Anycondition that decreases elimination of
carbon dioxide (pC02>40 mmHg)
Respiratory centre depressed
Trauma, tumor, infection, drugs
Respiratory apparatus affected
COPD, fibrosis, ARDS, trauma

25
 Buffer systems
Hemoglobin and protein buffers
Renal mechanism
Increased Na+H- exchange
Increased formation of ammonia
Increased reclamation of bicarbonate

26
 Carbonic acid deficit

pCO2 less than 35 mm Hg (hypocapnea)

Most common acid-base imbalance

Primary cause is hyperventilation

27
 Buffer systems
Hemoglobin and protein buffers
Renal mechanism
Decreased Na+H- exchange
Decreased formation of ammonia
Decreased reclamation of bicarbonate

28
A patient is in intensive care because he
suffered a severe myocardial infarction 3
days ago. The lab reports the following
values from an arterial blood sample:
pH 7.3
HCO3- = 20 mEq / L ( 22 - 26)
pCO2 = 32 mm Hg (35 - 45)

31
 Metabolicacidosis
With compensation

32