Acid base balance

Imporatance
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Importance for cell survival

Changes in blood ph will cause changes in intracellular pH, which in turn may
alter metabolism (enzymes)

Why acid base concept is important?

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Enzymes are pH dependednt

Ionic states of all substances which have acidic

Acid
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Proton donor, anything which dissociate into one/more protons

Strong acids dissociate completely and weak acids inoze incompletely

Determined by concentration of free H+ ions which is expressed by terme of

pH
Negative log of hydrogen ion concentration
pH is inversely proportional to H concentration
normal blood is pH 7.4 -+ 0.05
intracellular pH is lowrr than plasma pH
range of pH compatible with life is 6.8-7.7
ph is found by Henderson-hasselbach uqation
bllod pH is dependent on relative concentration to bicarbonate and carbonic
acid
if bicarbonate increases, pH increases

pH

academia
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greater than 45 mmol/L with low blood pH less than 7.35

acidosis
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process that generates excessive H+

Alkalemia
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low blood H+ less than 35 nmol/L with high blood pH

alkalosis
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process that low H+

Buffer
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substance that resist change in pH

has an ability to bind or release H+ in solution thus maintaining pH relatively

constant

Sources of acid in body

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by ingesting food. Look back metabolism of carb, lipid and protein

product of fat metabolism
protein catabolism is acidic in character
hydrolysis of peoptide bond is amino acid
nitrogen metabolism = urea (alkaline)

other consitions, cause acid load

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relaive excess due to loss of bicarbonate from lower parts of alimentary

canal. Eg diarrhea
ingestion of acidyfing salts like NH4cl
retention of CO2 as result of hypoventilation
retention of H+ as result of kidney disease

sources of alkali
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dietary source : ingestion of fruits and veggies

ingestion of alkanizing salts
lowered PCO2 due to hyperventilation = CO2 washout
relative excess due to loss of acid from upper part of GI tract = vomiting in
pyloric stenosis

pH homeostatsis by 3 mechanisms
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buffering. More less immediate

respiratory response. Delayed
renal system. Slowest

however, buffers are first line of defense.

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Solution of weak aid and its salt with a strong base

Resist change in pH

Blood buffers
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Buffers in plasma
Buffer in RBC

Interstitial fluid = same as plasma, lower protein conc

Intarcellular fluid = same in RBC, except no haemoglobin
Protein and phosphate system are more prominent
Mechanism of action of various buffer systems

Bicarbonate buffer system

Normal ratio of H2CO3
Protein buffer system = plasma protein and intracellular protein

Protein buffer system

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Amphoteric compuns, contain proton donating and protin accepting

In acidic medium, amino acid acts as base and absorbs H+
In alkali medium, amino acids acts as acid and releases H+
Most effective group is histidine imidazole with pK value of 6-7albumin is the
most abundant protein in plasma = 38residues per tetramer

Haemoglobin buffer system

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Deoxy hB and oxy Hb

Phosphate buffer
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Mainly intracellular
Principle buffer in normal urine

Respiratory regulation of pH
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Second line of defense

Mediated through elimination or retention of CO2
CO2 formed continuously within cells by various metabolic process
CO2 diffuse from cells into ECF, blood reaches lungs
It will stimulate hyperventilation, elimination of more CO2, lower

Renal regulation of pH
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Major kidney mechanisms

Exceretion of H
Reabsorption of filtered HCO3 via CO2. Formation of monobasic phosphate.
Ammonium ion formation.

Acid-base imbalance
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Hypercapnia
Hysteria
Metabolic alkalosis

Metabolic alkalosis
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Present when there is loss of acid H2Co3

Cause of metabolic alkalosis = vomiting, gain in base, NaHCO3 (sodamint in
excess), chloride depletion

Blood pH is increased in