ACID-BASE BALANCE

 BLOOD pH
 Acidity and alkalinity are expressed on the pH
scale, which ranges from 0 (strongly acidic) to
14 (strongly basic, or alkaline). A pH of 7.0, in
the middle of this scale, is neutral. Blood is
normally slightly basic, with a pH range of 7.35
to 7.45. To function properly, the body maintains
the pH of blood close to 7.40.
 An important property of blood is its degree of
acidity or alkalinity
 The body's balance between acidity and
alkalinity is referred to as acid-base balance
 The acidity or alkalinity of any solution,
including blood, is indicated on the pH scale.
The body uses different
mechanisms to control
the blood's acid-base
balance:
-Role of the Lungs: the release of CO2.

 Carbon dioxide, which is mildly acidic, is constantly

produced by cells and it gets excreted into the blood.
The blood carries carbon dioxide to the lungs, where
it is exhaled. As carbon dioxide accumulates in the
blood, the pH of the blood decreases (acidity
increases). The brain regulates the amount of carbon
dioxide that is exhaled by controlling the speed and
depth of breathing. The amount of carbon dioxide
exhaled, and consequently the pH of the blood,
increases as breathing becomes faster and deeper. By
adjusting the speed and depth of breathing, the brain
and lungs are able to regulate the blood pH minute
by minute.
-Role of the Kidneys: the excretion of acids
and bases.

 The kidneys are able to affect blood pH by

excreting excess acids or bases. The kidneys
have some ability to alter the amount of acid or
base that is excreted,but the kidneys make these
adjustments more slowly than the lungs
do(several days).
Buffer Systems:

 combinations of the body's own naturally occurring weak

acids and weak bases. (These weak acids and bases exist
in balance under normal pH conditions.) The pH buffer
systems work chemically to minimize changes in the pH
of a solution by adjusting the proportion of acid and base.
Any substance that can reversibly bind hydrogen ions is
called a buffering agent. They function to impede any
change in pH. Hydrogen ions are buffered by extracellular
(e.g., bicarbonate, ammonia) and intracellular buffering
agents (including proteins and phosphate). The buffering
ability of plasma acts as an immediate defense against pH
imbalance. The most important pH buffer system in the
blood involves carbonic acid (a weak acid formed from
the carbon dioxide dissolved in blood) and bicarbonate
ion.
Acidosis and Alkalosis
 There are two abnormalities of acid-base balance.
Acidosis: The blood has too much acid (or too little
base), resulting in a decrease in blood pH.( <7.4)
Alkalosis: The blood has too much base (or too little
acid), resulting in an increase in blood pH.(>7.4)
Acidosis and alkalosis are not diseases but rather are
the result of a wide variety of disorders. Acidosis and
alkalosis are categorized as metabolic or respiratory,
depending on their primary cause: -Metabolic acidosis
and metabolic alkalosis are caused by an imbalance in
the production of acids or bases and their excretion by
the kidneys. -Respiratory acidosis and respiratory
alkalosis are caused primarily by changes in carbon
dioxide exhalation due to lung or breathing disorders .
Acidosis

 Acidosis is excessive blood acidity caused by an

overabundance of acid in the blood or a loss of
bicarbonate from the blood (metabolic acidosis), or by a
buildup of carbon dioxide in the blood that results from
poor lung function or slow breathing (respiratory
acidosis). If an increase in acid overwhelms the body's pH
buffering systems, the blood will become acidic. As blood
pH drops, the parts of the brain that regulate breathing are
stimulated to produce faster and deeper breathing.
Breathing faster and deeper increases the amount of
carbon dioxide exhaled. The kidneys also try to
compensate by excreting more acid in the urine. However,
both mechanisms can be overwhelmed if the body
continues to produce too much acid, leading to severe
acidosis and eventually coma.
Major Causes of Metabolic
Acidosis
 Diabetic ketoacidosis (buildup of ketones) Drugs
and substances such as acetazolamide , alcohol,
aspirin , iron Lactic acidosis (buildup of lactic
acid as occurs in shock) Loss of bases, such as
bicarbonate, through the digestive tract from
diarrhea, an ileostomy, or a colostomy Kidney
failure Poisons such as carbon monoxide,
cyanide, ethylene glycol, methanol, Renal
tubular acidosis (a form of kidney malfunction)
Major Causes of
Respiratory Acidosis
 Lung disorders, such as emphysema, chronic
bronchitis, severe asthma, pneumonia, or
pulmonary edema Sleep-disordered breathing
Diseases of the nerves or muscles of the chest
that impair breathing, such as Guillain-Barré
syndrome or amyotrophic lateral sclerosis
Overdose of drugs such as alcohol, opioids, and
strong sedatives
Alkalosis
 Alkalosis is excessive blood alkalinity caused by
an overabundance of bicarbonate in the blood or
a loss of acid from the blood (metabolic
alkalosis), or by a low level of carbon dioxide in
the blood that results from rapid or deep
breathing (respiratory alkalosis). Metabolic
alkalosis Loss of acid from vomiting or drainage
of the stomach Overactive adrenal gland
(Cushing's syndrome) Use of diuretics
( furosemide , ethacrynic acid ) Respiratory
alkalosis Anxiety Aspirin overdose (early stages)
Fever Low levels of oxygen in the
blood(altitude) Pain