BIOCHEM LEC NOTES – Buffers, Acidosis, and Alkalosis

Buffers in Relation to Acidosis and Alkalosis

Action of Lungs and Blood Buffers (compensatory mechanism):

1) in the presence of excess acid

CO2(g) + H2O H2CO3 [H+] + HCO3-
weak acid conjugate base

• if there is excess acid, H+, the conjugate base HCO3- reacts with the H+ to form the weak
H2CO3, favoring backward reaction
• backward reaction decreases [H+] in the blood and initially increases pCO2 in the lungs
• since there is more CO2(g), the lungs hyperventilate to remove excess CO2(g) thus,
decreasing pCO2

2) in the presence of excess base

CO2(g) + H2O H2CO3 [H+] + HCO3-
weak acid conjugate base

• if there is excess base, OH-, the weak acid H2CO3 reacts with the OH- (H2CO3 + OH- →
HCO3- + H2O) to form the conjugate base HCO3-, favoring forward reaction
• forward reaction increases the [H+] in the blood and initially decreases pCO2 in the lungs
• since there is less CO2(g), the lungs hypoventilate to conserve CO2(g) thus,
increasing [CO2(g)]

Acid-Base Balance of the Blood

In Cases of Respiratory Acidosis: ↑[H+] = ↓pH

CO2(g) + H2O H2CO3 [H+] + HCO3-
weak acid conjugate base

lungs hypoventilate (hypoventilation - a symptom):

↑pCO2
↑[HCO3-]
• excess CO2(g) cannot be efficiently removed by the lungs (hypoventilation)
• equilibrium shifts to the right favoring forward reaction
• forward reaction increases [H+] (blood’s pH ≤ 7.35) and [HCO3-] resulting in respiratory
acidosis

CAUSES: 1) COPD (e.g. emphysema, pneumonia, asthma, pulmonary edema)

2) anesthesia
3) barbiturate overdose

TREATMENT: i.v. NaHCO3, treat the underlying causes e.g. with antibiotics

In Cases of Respiratory Alkalosis: ↓[H+] = ↑pH

CO2(g) + H2O H2CO3 [H+] + HCO3-
weak acid conjugate base

lungs hyperventilate (hyperventilation - a symptom):

↓pCO2
↓[HCO3-]
• CO2(g) is being removed rapidly by the lungs (hyperventilation)
• equilibrium shifts to the left favoring backward reaction
• backward reaction decreases [H+] (blood’s pH ≥ 7.35) and [HCO3-] resulting in respiratory
alkalosis

Prepared by: Asst. Prof. Marites D. Saludares, PhD / Chemistry Department, UST College of Science / mdsaludares@ust.edu.ph
CAUSES: 1) high altitude
2) anxiety, hysteria
3) fever

TREATMENT: rebreathe one’s own exhaled air using a paper bag, treat the underlying causes

In Cases of Metabolic Acidosis: ↑[H+] = ↓pH

CO2(g) + H2O H2CO3 [H+] + HCO3-
weak acid conjugate base
hyperventilation (a defense mechanism):

↓pCO2
↓[HCO3-]
• [H+] increases (blood’s pH ≤ 7.35) thus, equilibrium shifts to the left favoring backward
reaction
• backward reaction decreases [HCO3-] in the blood and initially increases pCO2
• to counteract metabolic acidosis, the lungs hyperventilate to decrease pCO2

CAUSES: 1) diabetes mellitus

2) severe diarrhea

TREATMENT: i.v. NaHCO3, insulin therapy, hemodialysis, treat the underlying causes

In Cases of Metabolic Alkalosis: ↓[H+] = ↑pH

CO2(g) + H2O H2CO3 [H+] + HCO3-
weak acid conjugate base
hypoventilation (a defense mechanism):

↑pCO2
↑[HCO3]
• [H+] decreases (blood’s pH ≥ 7.35) thus, equilibrium shifts to the right favoring forward
reaction
• forward reaction increases [HCO3-] in the blood and initially decreases pCO2
• to counteract metabolic alkalosis, the lungs hypoventilate and pCO2 increases

CAUSES 1) ingestion of large doses of alkali (e.g. antacids)

2) vomiting

TREATMENT: i.v. NH4Cl, treat the underlying causes

Buffers: Quantitative Aspects

in the lungs: in the blood: (buffer)

CO2(g) + H2O ↔ H2CO3 ↔ [H+] + HCO3-
weak acid/ CO2(aq) conjugate base

EQUILIBRIUM EXPRESSION: HENDERSON-HASSELBALCH EQUATION:

Ka = [H+][OH-] pH = pKa + log [HCO3-]
[CO2(aq)] [CO2(aq)]
Ka = 7.9 x 10-7 of CO2(aq) pKa = 6.1 of CO2

Prepared by: Asst. Prof. Marites D. Saludares, PhD / Chemistry Department, UST College of Science / mdsaludares@ust.edu.ph
Ratio of [HCO3-]/[CO2(aq)] in the blood: [HCO3-] = 24 mmol/L [CO2(aq)] = 1.2 mmol/L

EXAMPLE: excess acid = 10 mmol/L

after buffer action:

[HCO3-] = 14 mmol/L [CO2(aq)] = 11.2 mmol/L

pH = pKa + log [HCO3-]

[CO2(aq)]
pH = 6.1 + log (14/11.2)
pH = 6.2

after lung action:

[HCO3-] = 14 mmol/L [CO2(aq)] = 1.2 mmol/L

pH = pKa + log [HCO3-]

[CO2(aq)]
pH = 6.1 + log (14/1.2)
pH = 7.2

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HW – Blood Buffers

1) Using arrows (↑) or (↓), complete the table below that summarizes the changes observed in
respiratory acidosis/ alkalosis and metabolic acidosis/ alkalosis.

Condition pH pCO2 [HCO3-]

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

2) Hyperventilation is observed in what two conditions? What treatment goes with which condition?
Why?
3) In which condition is hypoventilation part of the problem rather than a cure? Explain.
4) In which condition is hypoventilation the body’s way of helping itself? Explain.
5) In respiratory and metabolic acidosis, in what way are these two conditions the same? In what way
are they different?
6) Explain the following situations. Specify the acid-base imbalance whether respiratory or metabolic.
a) Hyperventilation in hysterics causes alkalosis.
b) Emphysema leads to acidosis.
c) Prolonged vomiting leads to alkalosis.
d) Uncontrolled diarrhea can cause acidosis.
7) Suppose that normal human arterial blood is suddenly made to accept 11 mmol of HCl(aq) per liter of
blood.
a) What is the resulting pH of the blood if no CO2 is allowed to escape?
b) What is the resulting pH of the blood if 11 mmol/L of CO2 can be quickly exhaled?

Prepared by: Asst. Prof. Marites D. Saludares, PhD / Chemistry Department, UST College of Science / mdsaludares@ust.edu.ph