Fluid, Electrolyte & Acid-

Base Balance
Body Fluids
Your body is 66% water
Not evenly distributed separated into
compartments
Able to move back and forth thru the cell
membranes to maintain an equilibrium
Fluid Compartments
Intracellular fluid fluid inside cells [ICF]
Extracellular fluid fluid outside cells
and all other body fluids --- is plasma
[intravascular fluid], remaining is
interstitial fluid. Small amount is
localized as CSF, serous fluid, synovial
fluid, humors of eye & endo/perilymph of
ears
Edema
Condition in which fluid accumulates in
the interstitial compartment. Sometimes
due to blockage of lymphatic vessels or
by a lack of plasma proteins or sodium
retention
Fluid Balance
Amount in = amount out
Average daily intake is 2500 ml [ fluids,
food and metabolic water]
Average daily output is 2500 ml [ urine,
feces, perspiration, insensible
perspiration]
What can throw off these numbers?
Electrolyte Balance
Def: - concentration of individual
electrolytes in the body fluid compartments
is normal and remains relatively constant.
Electrolytes are dissolved in body fluids
Sodium predominant extracellular cation,
and chloride is predominant extracellular
anion. Bicarbonate also in extracellular
spaces
Electrolyte Balance
Potassium is the predominant
intracellular cation and phosphates are
the predominant intracellular anion
Cations are actively reabsorbed, anions
passively follow by electrochemical
attraction
Aldosterone works at kidney tubules to
regulate sodium & potassium levels

Electrolyte Balance
Because of sodium and potassium
influence, water will move between
compartments
Example: if high [sodium], then water
will move from intracellular space to
extracellular space due to osmotic
pressure
Balance of other Electrolytes
Calcium hypercalcemia / hypocalcemia
Magnesium hypermagnesemia/
hypomagnesemia
Phosphate hyperphosphatemia/
hypophosphatemia
Chloride hyperchloremia/
hypochloremia
Acid - Base Balance
Blood - normal pH of 7.2 7.45
< 7.2 = acidosis > 7.45 = alkalosis
3 buffer systems to maintain normal
blood pH
1. Buffers
2. Removal of CO
2
by lungs
3. Removal of H
+
ions by kidneys
Buffers
Protein Buffer Systems
Amino Acid buffers
Hemoglobin buffers
Plasma Protein buffers
Phosphate Buffer Systems
Carbonic Acid Bicarbonate Buffer
System

Maintenance of Acid-Base
Balance
Respiratory System: removal of CO
2
by
lungs stabilizes the ECF, has direct
effect on Carbonic Acid Bicarbonate
Buffer System

Urinary System: removal of H
+
ions by
kidneys

Disturbances to Acid-Base
Balance
Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis [ lactic acidosis,
ketoacidosis]
Metabolic Alkalosis
www.nda.ox.ac.uk/ wfsa/html/u13/u1312_02.htm