ACID BASE BALANCE

Acids and Base

• According to Lowry and Bronsted:
an acid is defined as a substance that gives off protons
while base is a substance that accepts protons.
 Acids
Substances that are ionized in dilute aqueous solutions to liberate
protons  commonly referred to as ‘proton donors’
Strong acids
Ionised completely in solution
Weak acids
It is partially ionized in solution
Base
Substances that accept protons in aqueous solutions, and
commonly known as ‘proton acceptors’.
• Strong base
• Greater tendency to accept proton
• Weak base
• Weaker tendency to accept protones
pH : Hydrogen ion concentration
• Determine acidic or basic nature of a solution
• Sorenson (1909)- term ‘pH’ to express H+ ion concentration
• Definition of pH:
• The negative logarithm of H+ ion concentration
pH= -log [H+]
pH- only measure in aqueous solution
(if there is no water, there is no pH)
pH of blood-7.4, acid-pH<7, base pH>7
• H+ ion concentration has no conventional units???
• Strength of H+ ions in a biological fluids are exceedingly low
Scale /range of pH
• Range from 0 to 14
• Corresponds to 1M solution to 10-14 solution of H+ ion concentration
• 1M solution of [H+] = pH is 0
• 10-14 solution of [H+] = pH is 14
H2O  H+ + OH-
• [OH- ] is reverse to [H+]
pH=0 [H+] =1 [OH- ]= 10-14
pH=14 [H+] = 10-14 [OH- ] =1
[H+] [OH- ]= 10-14
• Neutral solution [OH- ] and [H+] has equal value concentration 10-7
Nature of the solution:
• Depends on [H+]
• pH less than 7  acidic nature
• pH more than 7  basic nature
• Strength of acid/ base depends on the shift from the neutral (7)
 Buffers
• pH of solution can be easily altered with addition of an acid or a base
• Definition:
• The solutions which resist change in pH by the addition of small
amounts of acids or bases .
• Composition of a Buffers:
• A weak acid and its salt
• Eg: acetic acid, Na accetate
• A weak base and its salt
• Eg: ammonium hydroxide , ammonium chloride
Mechanism of action of buffer
Major body buffers

• Blood buffers
• 1st line defence
• Respiratory regulation
• 2nd line defence
• Renal regulation
• 3rd line defence
Blood buffers
• 1st line defence

Effective as long as the acid load is not excessive and alkali

reserve is not exhausted

• Bicarbonate buffer system

• Phosphate buffer

• Protein buffer
Bicarbonate buffer system Phosphate buffer Protein buffer
• Most predominant • Intracellular buffer • Plasma protein
• Bicarbonate- carbonic acid and
• Sodium dihydrogen haemoglobin
system
phosphate and • Have
• H2CO3 H+ + HCO3-
disodium hydrogen aminoacids
• Base  HCO3- (renal-metabolic) which behave as
phosphate
• Acid  H2CO3 (lungs- weak acids
respiratory) • Most effective buffer • histidine
• Normal value: in the blood presence of
imidazole group
• HCO3-- 24mmol/L • Low concentration
• Hb buffer the
• pCO3 (a)- 40mmof hg
fixed acids
• H2CO3 - 1.2 mmol/L
Respiratory mechanism of pH Renal regulation of pH

• 2nd line defence • Regulate pH of extracellular fluid

• Regulation of concentration of • Major renal mechanism for
carbonic acid in blood
regulation of pH
• Medulla-highly sensitive to pH
• Excretion of H+
• Increase pHmedulla
hyperventilation blow off CO2
• Reabsorption of bicarbonate
decrease acid • Excreation of titratable acids
• Hb help in resp. regulation bind • Excretion of ammonium ions
with H+ ion & transportation of CO2
• Provide permanent solution for
• Short term regulation
acid base disturbance
Acid Base Disorder
• The body has developed an efficient system for the maintenance
of acid-base equilibrium with a result that the pH of blood is
almost constant (7.4).
• The blood pH compatible to life is 6.8-7.8
The acid-base disorders are mainly classified as
• Acidosis—a decline in blood pH
• Metabolic acidosis —due to a decrease in bicarbonate.
• Respiratory acidosis —due to an increase in carbonic acid.
• Alkalosis—a rise in blood pH
• Metabolic alkalosis —due to an increase in bicarbonate.
• Respiratory alkalosis —due to a decrease in carbonic acid
Clinical causes of acid-base disorders
• Metabolic acidosis
• diabetes mellitus (ketoacidosis)
• Lactic acidosis
• Renal failure etc.
• Respiratory acidosis - severe asthma and cardiac arrest .
• Metabolic alkalosis - vomiting and hypokalemia
• Respiratory alkalosis- hyperventilation and severe anemia
Metabolic acidosis

• Metabolic
  acidosis is occur due to deficit of bicarbonateleads to a
fall in blood Ph
• Blood values: blood pH-, HCO3 –, H 2 CO3 -normal
• Cause of reduction of bicarbonate: its utilization in buffering H+ ions,
loss in urine or gastrointestinal tract or failure to be regenerated.
• The most important cause of metabolic acidosis is due to an excessive
production of organic acids which combine with NaHCO3 – and
deplete the alkali reserve.
• occur in severe uncontrolled diabetes mellitus, renal failure, severe
diarrhoea
Compensatory mechanism:
• Hyperventilation of lungs  an increased elimination of CO2 from
the body
• Respiratory compensation is only short-lived.
• Renal compensation sets in within 3-4 days and the h+ ions are
excreted as nh4+ ions
Respiratory acidosis
•  Due to retention of CO2
• Carbonic acid is increase
• Blood values: pH-, HCO3 –, H 2 CO3 –
Cause of respiratory acidosis:
• depression of the respiratory centre (overdose of drugs)
• pulmonary disorders (bronchopneumonia)
• breathing air with high content of CO2.
Compensatory mechanism:
• More HCO3 – is generated and retained by the kidneys which
adds up to the alkali reserve of the body.
• The excretion of titratable acidity and NH4 + is elevated in urine
.
Metabolic alkalosis
•  Increase in HCO 3 – concentration .
• Blood value: ph-, HCO3 –, H 2 CO3 –,
• Metabolic alkalosis is commonly associated with low K+
concentration
Causes:
• Excessive vomiting (resulting in loss of H+)
• Excessive intake of sodium bicarbonate for therapeutic purposes
• Cushing’s syndrome
• Compensatory mechanism
Compensation by hypoventilation to retain CO2
• Renal mechanism which excretes more HCO3 – and retains H+.
Respiratory alkalosis
•  Decrease in H 2 CO 3 concentration .
• Blood value: ph-, HCO3 –, H 2 CO3 –
Causes:
• Prolonged hyperventilation resulting in increased exhalation of CO2
by the lungs.
• Hysteria
• Hypoxia
• Raised intracranial pressure
• Excessive artificial ventilation
• Action of certain drugs (salicylate) that stimulate respiratory centre.
• The renal mechanism tries to compensate by increasing the urinary
excretion of HCO3 –
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