A physiological approach to acid–base disorders: The roles of ion transport and body fluid compartments

2020 ◽  
pp. 2182-2198
Author(s):  
Julian Seifter
Keyword(s):  
Metabolic Acidosis ◽  
Gas Analysis ◽  
Hydrogen Ion ◽  
Anion Gap ◽  
Ion Concentration ◽  
Hydrogen Ions ◽  
Acid Base ◽  
Hydrogen Ion Concentration ◽  
Arterial Blood Gas ◽  
Fluid Compartments

The normal pH of human extracellular fluid is maintained within the range of 7.35 to 7.45. The four main types of acid–base disorders can be defined by the relationship between the three variables, pH, Pco2, and HCO3 –. Respiratory disturbances begin with an increase or decrease in pulmonary carbon dioxide clearance which—through a shift in the equilibrium between CO2, H2O, and HCO3 –—favours a decreased hydrogen ion concentration (respiratory alkalosis) or an increased hydrogen ion concentration (respiratory acidosis) respectively. Metabolic acidosis may result when hydrogen ions are added with a nonbicarbonate anion, A−, in the form of HA, in which case bicarbonate is consumed, or when bicarbonate is removed as the sodium or potassium salt, increasing hydrogen ion concentration. Metabolic alkalosis is caused by removal of hydrogen ions or addition of bicarbonate. Laboratory tests usually performed in pursuit of diagnosis, aside from arterial blood gas analysis, include a basic metabolic profile with electrolytes (sodium, potassium, chloride, bicarbonate), blood urea nitrogen, and creatinine. Calculation of the serum anion gap, which is determined by subtracting the sum of chloride and bicarbonate from the serum sodium concentration, is useful. The normal value is 10 to 12 mEq/litre. An elevated value is diagnostic of metabolic acidosis, helpful in the differential diagnosis of the specific metabolic acidosis, and useful in determining the presence of a mixed metabolic disturbance. Acid–base disorders can be associated with (1) transport processes across epithelial cells lining transcellular spaces in the kidney, gastrointestinal tract, and skin; (2) transport of acid anions from intracellular to extracellular spaces—anion gap acidosis; and (3) intake.

Metabolic acidosis developing during cardiopulmonary bypass is related to a decrease in strong ion difference

Perfusion ◽  
2004 ◽  
Vol 19 (3) ◽  
pp. 145-152 ◽  
Author(s):  
R Peter Alston ◽  
Laura Cormack ◽  
Catherine Collinson
Keyword(s):  
Metabolic Acidosis ◽  
Lactate Concentration ◽  
Gas Analysis ◽  
Hydrogen Ion ◽  
Ion Concentration ◽  
Outcome Variable ◽  
Royal Infirmary ◽  
Strong Ion Difference ◽  
Hydrogen Ion Concentration ◽  
Arterial Blood

Metabolic acidosis is a frequent complication of cardio-pulmonary bypass (CPB). Commonly, its cause is ascribed to hypoperfusion; however, iatrogenic causes, related to the composition and volume of intravascular fluids that are administered, are increasingly being recognized. The aim of this study was to determine if metabolic acidosis during CPB was associated with hypoperfusion, change in strong ion difference (SID) or haemodilution. Forty-nine patients undergoing cardiac surgery using CPB in the Royal Infirmary of Edinburgh (RIE) or the HCI, Clydebank were included in the study. Arterial blood samples were aspirated before induction of anaesthesia and the end of CPB. Samples were subjected to blood gas analysis and measurement of electrolytes and lactate. Changes in concentrations were then calculated. Change variables that were found to be significant (p B-0.1) univariate correlates of the change in hydrogen ion concentration were identified and entered into a multivariate regression model with hydrogen ion concentra tion at the end of CPB as the outcome variable (r2=0.65, p<0.001). Change variance in hydrogen ion concentration was created by first entering the baseline hydrogen ion concentration into the model. Next, any variance resulting from the respiratory component of acidosis was removed by entering the change in arterial carbon dioxide tension (regression coefficient (β)=0.67, p<0.01). Change in SID (β=-0.34, p<0.01) and surgical institution (β=-0.40, p<0.01) were then found to be predictors of the remaining variance whilst change in concentration of lactate (β in=0.16, p=0.07) and volume of intravascular fluid that was administered (β=-0.07, p=0.52) were rejected from the model. These findings suggest that the metabolic acidosis developing during CPB is partially the result of iatrogenic decrease in SID rather than hypoperfusion, as estimated by lactate concentration, or haemodilution.

Disturbances of acid–base homeostasis

2010 ◽  
pp. 1738-1751
Author(s):  
R. D. Cohen ◽  
H. F. Woods
Keyword(s):  
Hydrogen Ion ◽  
Ion Concentration ◽  
Hydrogen Ions ◽  
Acid Base ◽  
Hydrogen Ion Concentration ◽  
Arterial Blood ◽  
Acidic Conditions ◽  
Daily Load ◽  
Alkaline Range

Despite a daily load of protons, derived mainly from metabolism, the hydrogen ion concentration of arterial blood in health is tightly maintained within a slightly alkaline range (pH 7.36–7.42); concentrations of intracellular hydrogen ions are also controlled. Failure adequately to excrete or neutralize protons causes acidic conditions to prevail (decreased pH): undue intake of base, uncompensated loss of protons—or the substrates from which they are derived—induces an alkaline milieu (raised pH)....

scholarly journals The Hydrogen Ion Concentration in the Gut of certain Lamellibranchs and Gastropods

1925 ◽  
Vol 13 (4) ◽  
pp. 938-952 ◽  
Author(s):  
O. M. Yonge
Keyword(s):  
Mantle Cavity ◽  
Mya Arenaria ◽  
Hydrogen Ion ◽  
Ion Concentration ◽  
Pecten Maximus ◽  
Hydrogen Ions ◽  
Acid Media ◽  
Hydrogen Ion Concentration ◽  
Acid Reaction ◽  
Acid Region

1. In the Lamellibranchs, as typified by Pecten maximus, Mya arenaria and Ensis siliqua, the entire, gut has an acid reaction, the stomach being the most acid region and the pH rising along the mid-gut and rectum.2. The origin of the acidity of the gut lies in the style. This has a low pH (5·4 in Pecten and Mytilus, 4·6 in Ensis and 4·45 in Mya), and, after it has been artificially extracted from Mya or induced to disappear, by keeping the animals under abnormal conditions, in Mytilus, Tapes and Pecten, the pH of the stomach invariably rises (by as much as 0·825 in Mya and 0·72 in Tapes), although the pH in the mantle cavity has fallen.3. The style, which dissolves rapidly in alkaline or weakly acid media, is not dissolved in fluids below a certain pH—4·4 for Ensis, 4·2 for Mya, 3·6 for Pecten and Mytilus.4. The style is never absent, even though animals are starved, so long as they are kept under otherwise healthy conditions. The disappearance of the style under abnormal conditions is probably due to a lowering of the vital activities, which include the secretion of the style substance, and the consequent dissolution of the style by the less acid contents of the stomach.5. The style is only maintained as a result of a balance between the rate of its secretion and the rate of its dissolution.6. There is a well-marked correlation between the tolerance of the presence of hydrogen ions possessed by the cilia from the various regions of the gut and the degree of acidity of the fluid with which they are normally surrounded.7. The pH of the gut in five Gastropods has been investigated. The fore-gut and stomach have invariably the lowest pH.8. This acidity may be caused by the salivary glands (Patella and Buccinum), the digestive gland (Doris and Aplysia), or the style (Crepidula).9. The mid-gut and rectum have a high pH, except in Doris, where there is little secretion of mucus, the gut being free and muscular.10. The style of Orepidula has similar properties to those of the Lamellibranchs. It has a pH of 5·8, and is not dissolved in fluid of pH 3·6 or lower.11. The cilia from the gut of Buccinum and Doris can function in a pH of 5·0, but there is little difference in the toleration of the various cilia to the presence of hydrogen ions.

Memoirs: The Spermatheca of Loligo Vulgaris. I. Structure of the Spermatheca and Function of its Unicellular Glands

1938 ◽  
Vol s2-80 (320) ◽  
pp. 593-599
Author(s):  
G. J. van OORDT
Keyword(s):  
Sea Water ◽  
Goblet Cells ◽  
Hydrogen Ion ◽  
Ion Concentration ◽  
Hydrogen Ions ◽  
Hydrogen Ion Concentration ◽  
Loligo Vulgaris ◽  
And Function

The structure of the spermatheca of Loligo vulgaris is described; it lies on the inner wall of the buccal membrane and within it large quantities of inactive spermatozoa are stored. This inactivity of the spermatozoa within the spermatheea is attributed to the effect of the secretion of the goblet-cells, situated as unicellular glands on the inner wall of the spermatheca. Inactive spermatozoa from the spermatheca become very active in sea-water, but are immobilized again after a few moments' contact with the pulp of the spermatheca contents. The hydrogen-ion concentration of the spermatheca contents is approximately 6.06; and, since spermatozoa become inactive in sea-water, the hydrogen-ion concentration of which is increased to this level, it seems probable that the inactivity of the spermatozoa within the spermatheca is due to the presence of hydrogen-ions. The spermatheca is functionally comparable to the mammalian epididymis.

scholarly journals SOME CONSEQUENCES OF THE THEORY OF MEMBRANE EQUILIBRIA

1925 ◽  
Vol 9 (1) ◽  
pp. 97-109 ◽  
Author(s):  
David I. Hitchcock
Keyword(s):  
Membrane Potential ◽  
Osmotic Pressure ◽  
Ionization Constant ◽  
Weak Acid ◽  
Hydrogen Ion ◽  
Ion Concentration ◽  
Weak Base ◽  
Acid Base ◽  
Hydrogen Ion Concentration ◽  
Pass Through

In applying Donnan's theory of membrane equilibria to systems where the non-diffusible ion is furnished by a weak acid, base, or ampholyte, certain new relations have been derived. Equations have been deduced which give the ion ratio and the apparent osmotic pressure as functions of the concentration and ionization constant of the weak electrolyte, and of the hydrogen ion concentration in its solution. The conditions for maximum values of these two properties have been formulated. It is pointed out that the progressive addition of acid to a system containing a non-diffusible weak base should not cause the value of the membrane potential to rise, pass through a maximum, and fall, but should only cause it to diminish. It is shown that the theory predicts slight differences in the effect of salts on the ion ratio in such systems, the effect increasing with the valence of the cation.

Effect of norepinephrine on myocardial intracellular hydrogen ion concentration

1975 ◽  
Vol 229 (2) ◽  
pp. 344-349 ◽  
Author(s):  
KM Riegle ◽  
RL Clancy
Keyword(s):  
Metabolic Acidosis ◽  
Respiratory Acidosis ◽  
Hydrogen Ion ◽  
Ion Concentration ◽  
Beta Blockade ◽  
Hydrogen Ion Concentration ◽  
Rat Hearts ◽  
Buffer Value

The effect of norepinephrine (NE) on the intracellular hydrogen ion concentration [H+]i of isolated rat hearts perfused with a modified Krebs-Henseleit solution (SHS) was determined. The [H+]i was calculated with the [14C]-dimethyloxazolidinedione method. Respiratory or metabolic acidosis was produced by equilibrating the KHS with 20% C02 or decreasing the [HC03-] of the KHS, respectively. Three types of experiments were carried out: 1) beta blockade--MJ 1999 (Sotalol) was added to the KHS; 2) control--no pharmacological treatment; and 3) NE-norepinephrine was added to the KHS. The effective CO2 buffer values (delta[HC03-]i/deltapHi) during respiratory acidosis were: beta blockade, 11; control, 35; and NE, 84. The production of metabolic acidosis resulted in the following [H+]i changes: beta blockade, 52 mM; control, 60 nM; and NE 7 nM. These results suggest that NE markedly attenuates the changes in [H+]i accompanying respiratory and metabolic acidosis and may account in part for previous observations that the effective C02 buffer value of cardiac muscle in vivo is greater than that in vitro.

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