Blood Gases, pH, and Buffer

system
Part 1

Introduction
Acid: substances that yields H ions or
hydronium in H2O.
Base: yields a hydroxyl ion (OH).
Substance ability to dissociate is based on
strength of acids and base (ionizaton
constant-K value)

Introduction
Acid: have a larger K value: greater
ability to dissociate into ions in H2O
pK: defined as the negative log of the
ionization constant; that is pH where the
protonated and unprotonated forms are
present in equal concentration.

Strong acids vs. Strong Base

Strong acids: have pK value of less than
3.0
Strong base: have a pK value greater than
9.0
Buffer: a combination of weak acid or
weak base and its salt

Acid-Base balance
Maintenance of hydrogen ions:
Body produces 40-80 mmol of H/day,
normal concentration of H in ECF ranges from
36-44 nmol of hydrogen ion.
Any deviation from the values the body will try to
compensate.
>44 nmol/L: altered consciousness, coma- death
<36 nmol/L: neuromuscular irritability, tetany,
loss of consciousness- death.
5

Concentration of H ions and pH

Reciprocal relationship in the

concentration of H ions and pH
Increase pH: decrease in H ion
Decrease pH: increase H ions
Arterial blood pH is controlled by:
1. Buffers
2. Respiratory System
3. Kidneys
6

Buffer System: Regulation of H

First line of defense to changes in H+ consist of

weak acid (H2CO3) & its salt (HCO3)
Add acid to the bicarbonate-carbonic acid
system- the HCO3 combines with H from the
acid to form H2CO3.
Add a base to the system, H2CO3 combines with
OH to form H2O and HCO3
Keeps the body at the correct pH (7.35-7.45)

Buffer System: Regulation of H

Bicarbonate carbonic acid system has

low buffering capacity but still an
important buffer system for 3 reasons
1. H2CO3 dissociates into CO2 & H2O allowing H+ to
be eliminated as CO2 by lungs
2. Changes in PCO2 modify the ventilation rate
3. HCO3 conc. can be altered by kidney

Other systems
HPO42 H2PO4 system
proteins are capable of binding H +.
Hemoglobin

Respiratory system
End product of aerobic metabolic process
is CO2, this diffuses out the tissue into
plasma and RBC.
It combines with H2O to form H2CO3
(carbonic acid), then dissociates into
hydrogen ions which is buffered by plasma
proteins.

10

RBC regulation
CO2 and O2 exchange, some CO2 remains
in the RBC in combination to HB
CO2 combines to water to form carbonic
acid and is transported in the blood.
Carbonic anhydrase enzymes in the RBC
accelerate this process
(CO2 + H2OH2CO3(
11

Chloride Shift- (lungs)

Hydrogen ions dissociate to HCO3
O2 picked up in the lungs- unloads
oxyhemoglobulin (O2Hb) in tissue.
Hb accepts hydrogen ion to form
deoxyhemoglobulin.
HCO3 increases in RBC it will diffuse out
into the plasma, to keep electrically neutral
plasma, chloride diffuses into the cells.
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Respiratory effects
Hydrogen ions carried on the
deoxyhemoglobulin in blood circulation
(H2CO3H2O + CO2)
CO2 is released in the lungs
If CO2 cannot be removed sufficiently there is
an increase in hydrogen ions-causes a decrease
in pH.
If CO2 removed too quickly there is a decrease
in hydrogen ions, causes an increase in pH.
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14

Kidney system

Main role is by reclaiming bicarbonate

Kidneys respond to increase or decrease in
hydrogen ions by selectively excreting or
reabsorbing:
1.
2.
3.
4.
5.
6.

Hydrogen ions
Sodium
Chloride
Phosphate
Ammonia
Bicarbonate
15

Reabsorption of Bicarbonate
Reabsorbing of bicarbonate (HCO3) takes
place in the renal tubule cells.
Na is exchanged for H ion.
H ion combines with the HCO3 and carbonic
acid dissociates into H2O and CO2.
CO2 diffuses into the tubule cells combining
with H2O forming H2CO3.
Reabsorption of bicarbonate in the blood
system.
Urinary H+ combines with HPO4 and NH3.
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17

Acid-Base Disorders
Acidosis (decrease pH) acidemia
vs. Alkalosis (increased pH) alkalemia
metabolic or respiratory
Inadequate elimination and excess production of
CO2 in the body.
Body compensates by respiration rate and
kidney.

18

Acidosis
1. Metabolic (non-respiratory) Acidosis

Respiratory compensation:

Decrease pH, increase H

Bicarbonate decreased (<24 mmol/L)
Reduce excretion of acids
Caused by acid producing substance or process
Hyperventilation, decrease CO2 in circulation.

Renal compensation:

increase H ion loss by increasing PO4 and NH4

excretion and retain HCO3
19

Acidosis
2. Respiratory Acidosis:
caused by hypoventilation (decrease the elimination
of CO2 in the lungs, it builds up in the blood)
In plasma increase in CO2 decrease in pH,
increase in H and HCO3
Diseases: emphysema, drugs , congestive heart
failure, bronchopneumonia.

Respiratory compensation
hyperventilation

Renal compensation
increase H excretion & increase reabsorption of
HCO320

Alkalosis
1. Metabolic alkalosis:

pH increased, H decreased, CO2 increased, HCO3

increased.
Causes of nonrespiratory alkalosis:

Respiratory compensation

excess administration of Na HCO3

ingestion of HCO3 producing salts such as Na-lactate, citrate
or acetate
excessive loss of acid through vomiting

Hypoventilation with CO2 retention

Renal compensation

excrete HCO3 and retain H ions.

21

Alkalosis
2. Respiratory alkalosis:
increased pH, decreased H, decreased
CO2, decreased HCO3.

Renal compensation
decrease renal excretion of H ions, HCO3
excreted.

Respiratory compensation
increase CO2 by hyperventilation
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