Acidosis/alkalosis
This article waslast modified on 31 January 2019. Acidosis and alkalosis are terms used to describe abnormal conditions when a patients blood pH may not fall within the healthy range. Measuring the hydrogen ion concentration, and calculating the pH , of blood is a way of finding out how acidic or alkaline the blood is. Normal blood pH must be within a narrow range of 7.35-7.45 so that the bodys metabolic processes can work properly and can deliver the right amount of oxygen to tissues. Many diseases and other conditions can cause a patients blood pH to fall outside of these healthy limits. In the human body, normal metabolism generates large quantities of acids (effectively compounds that produce a free hydrogen ion) that must be removed to keep a normal pH balance. Disruption of this balance can be caused by a build-up of acid or alkali (base) or by an increased loss of acid or alkali (see the diagram of taps and drains below). Alkalis, or bases, are compounds that remove a free hydrogen ion. Acidosis occurs when blood pH falls below 7.35, indicating an increase in hydrogen ion concentration. Alkalosis occurs when blood pH rises above 7.45, indicating a reduction in hydrogen ion concentration. Both of these conditions act as an alarm to the body; they trigger actions intended to restore the balance and to return the blood pH to its normal range. The major organs involved in regulating blood pH are the lungs and the kidneys. The lungs flush acid out of the body by exhaling carbon dioxide (CO2), which forms an acid when in solution (dissolved in the blood). Within physical limits, the body can raise and lower the rate of breathing to alter the amount of carbon dioxide that is breathed out. This can affect blood pH within seconds to minutes. The kidneys remove some acids Continue reading >>
Respiratory Acidosis
Respiratory Acidosis Definition Respiratory acidosis is a condition in which a build-up of carbon dioxide in the blood produces a shift in the body's pH balance and causes the body's system to become more acidic. This condition is brought about by a problem either involving the lungs and respiratory system or signals from the brain that control breathing. Description Respiratory acidosis is an acid imbalance in the body caused by a problem related to breathing. In the lungs, oxygen from inhaled air is exchanged for carbon dioxide from the blood. This process takes place between the alveoli (tiny air pockets in the lungs) and the blood vessels that connect to them. When this exchange of oxygen for carbon dioxide is impaired, the excess carbon dioxide forms an acid in the blood. The condition can be acute with a sudden onset, or it can develop gradually as lung function deteriorates. Causes and symptoms Respiratory acidosis can be caused by diseases or conditions that affect the lungs themselves, such as emphysema, chronic bronchitis, asthma, or severe pneumonia. Blockage of the airway due to swelling, a foreign object, or vomit can induce respiratory acidosis. Drugs like anesthetics, sedatives, and narcotics can interfere with breathing by depressing the respiratory center in the brain. Head injuries or brain tumors can also interfere with signals sent by the brain to the lungs. Such neuromuscular diseases as Guillain-Barré syndrome or myasthenia gravis can impair the muscles around the lungs making it more difficult to breathe. Conditions that cause chronic metabolic alkalosis can also trigger respiratory acidosis. The most notable symptom will be slowed or difficult breathing. Headache, drowsiness, restlessness, tremor, and confusion may also occur. A rapid heart rate Continue reading >>
Respiratory Compensation
Metabolic Acidosis Respiratory compensation for metabolic disorders is quite fast (within minutes) and reaches maximal values within 24 hours. A decrease in Pco2 of 1 to 1.5 mm Hg should be observed for each mEq/L decrease of in metabolic acidosis.27 A simple rule for deciding whether the fall in Pco2 is appropriate for the degree of metabolic acidosis is that the Pco2 should be equal to the last two digits of the pH. For example, compensation is adequate if the Pco2 decreases to 28 when the pH is 7.28. Alternatively, the Pco2 can be predicted by adding 15 to the observed (down to a value of 12). Although reduction in Pco2 plays an important role in correcting any metabolic acidosis, evidence suggests that it may in some respects be counterproductive because it inhibits renal acid excretion. Fetoplacental Elimination of Metabolic Acid Load Fetal respiratory and renal compensation in response to changes in fetal pH is limited by the level of maturity and the surrounding maternal environment. However, although the placentomaternal unit performs most compensatory functions,3 the fetal kidneys have some, although limited, ability to contribute to the maintenance of fetal acid–base balance. The most frequent cause of fetal metabolic acidosis is fetal hypoxemia owing to abnormalities of uteroplacental function or blood flow (or both). Primary maternal hypoxemia or maternal metabolic acidosis secondary to maternal diabetes mellitus, sepsis, or renal tubular abnormalities is an unusual cause of fetal metabolic acidosis. Pregnant women, at least in late gestation, maintain a somewhat more alkaline plasma environment compared with that of nonpregnant control participants. This pattern of acid–base regulation in pregnant women is present during both resting and after maximal e Continue reading >>
Shared Flashcard Set
Details Title Acid Base Balance Description Acid Base Balance Total Cards 214 Subject Nursing Level Undergraduate 2 Created 10/14/2012 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Nursing Flashcards Cards Term An opioid drug overdose would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Pulmonary Edema would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Chest trauma would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Neuromuscular disease would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term COPD would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Airway obstruction would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Pneumonia would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term TB would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Emphysema would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Asthma would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Cigarrette smoking would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Pleural effusion would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term What is pleural effusion? Definition excess fluid that accumulates in the pleura, the fluid-filled space that surrounds the lungs Pleural effusion is excess fluid that accu Continue reading >>
What Is Metabolic Acidosis?
Metabolic acidosis happens when the chemical balance of acids and bases in your blood gets thrown off. Your body: Is making too much acid Isn't getting rid of enough acid Doesn't have enough base to offset a normal amount of acid When any of these happen, chemical reactions and processes in your body don't work right. Although severe episodes can be life-threatening, sometimes metabolic acidosis is a mild condition. You can treat it, but how depends on what's causing it. Causes of Metabolic Acidosis Different things can set up an acid-base imbalance in your blood. Ketoacidosis. When you have diabetes and don't get enough insulin and get dehydrated, your body burns fat instead of carbs as fuel, and that makes ketones. Lots of ketones in your blood turn it acidic. People who drink a lot of alcohol for a long time and don't eat enough also build up ketones. It can happen when you aren't eating at all, too. Lactic acidosis. The cells in your body make lactic acid when they don't have a lot of oxygen to use. This acid can build up, too. It might happen when you're exercising intensely. Big drops in blood pressure, heart failure, cardiac arrest, and an overwhelming infection can also cause it. Renal tubular acidosis. Healthy kidneys take acids out of your blood and get rid of them in your pee. Kidney diseases as well as some immune system and genetic disorders can damage kidneys so they leave too much acid in your blood. Hyperchloremic acidosis. Severe diarrhea, laxative abuse, and kidney problems can cause lower levels of bicarbonate, the base that helps neutralize acids in blood. Respiratory acidosis also results in blood that's too acidic. But it starts in a different way, when your body has too much carbon dioxide because of a problem with your lungs. Continue reading >>
Acidosis
For acidosis referring to acidity of the urine, see renal tubular acidosis. "Acidemia" redirects here. It is not to be confused with Academia. Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increased hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states. Nevertheless, the terms are sometimes used interchangeably. The distinction may be relevant where a patient has factors causing both acidosis and alkalosis, wherein the relative severity of both determines whether the result is a high, low, or normal pH. Acidosis is said to occur when arterial pH falls below 7.35 (except in the fetus – see below), while its counterpart (alkalosis) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes. The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g., healthy human-arterial blood pH varies between 7.35 and 7.45). Blood pH values compatible with life in mammals are limited to a pH range between 6.8 and 7.8. Changes in the pH of arterial blood (and therefore the extracellular fluid) outside this range result in irreversible cell damage.[1] Signs and symptoms[edit] General symptoms of acidosis.[2] These usually accompany symptoms of another primary defect (respiratory or metabolic). Nervous system involvement may be seen with acidosis and occurs more often with respiratory acidosis than with metabolic acidosis. Signs and symptoms that may be seen i Continue reading >>
Respiratory Acidosis: Causes And Regulation
This lesson will discuss an important relationship between the kidneys and the lungs and how both of them play a role in respiratory acidosis. We'll also discuss some of the major causes of respiratory acidosis. Mutualistic Relationships A mutualistic relationship refers typically to a couple of different species of animals helping one another out. Take, for example, the birds that clean an alligator's teeth. The alligator gets a free dental exam, no insurance necessary, and the birds get a nice meal. It's really weird in a way that a bird and a reptile would rely on one another. They are just so different in terms of their size, function, and appearance, but their relationship is nonetheless very important. Well, the kidneys have a relationship with the lungs that is equally weird but important. I mean, the lungs are much bigger, look totally different, and don't seem to be related to the kidneys at all! But these two organ systems are in a very important mutualistic relationship, only one fourth of which can be discussed in this lesson. A Couple of Important Terms Before we get to everything, I want to clarify some terms. 'Acidemia' refers to an abnormally low pH of the blood. pH is inversely proportional to the concentration of H+ (hydrogen ions, aka protons). Hydrogen ions confer acidity upon a substance. So if we raise the concentration of hydrogen, we actually lower the pH. Acidemia is a result of acidosis. 'Acidosis' refers to a pathological state or process that leads to acidemia. We'll be using these terms later, so keep them in mind. To help remember that acid has a low pH, just think about the fact that gastric acid sits 'down' in your stomach. Therefore, something acidic moves 'down' the pH scale. Respiratory Acidosis Okay, with that out of the way for a bit Continue reading >>
Acid-base Balance
Your blood needs the right balance of acidic and basic (alkaline) compounds to function properly. This is called the acid-base balance. Your kidneys and lungs work to maintain the acid-base balance. Even slight variations from the normal range can have significant effects on your vital organs. Acid and alkaline levels are measured on a pH scale. An increase in acidity causes pH levels to fall. An increase in alkaline causes pH levels to rise. When the levels of acid in your blood are too high, it’s called acidosis. When your blood is too alkaline, it is called alkalosis. Respiratory acidosis and alkalosis are due to a problem with the lungs. Metabolic acidosis and alkalosis are due to a problem with the kidneys. Each of these conditions is caused by an underlying disease or disorder. Treatment depends on the cause. When you breathe, your lungs remove excess carbon dioxide from your body. When they cannot do so, your blood and other fluids become too acidic. Symptoms of respiratory acidosis Symptoms may include fatigue, shortness of breath, and confusion. Causes of respiratory acidosis There are several different causes of respiratory acidosis including: chest deformities or injuries chronic lung and airway diseases overuse of sedatives obesity Types of respiratory acidosis There are no noticeable symptoms of chronic respiratory acidosis. This is due to the fact that your blood slowly becomes acidic and your kidneys adjust to compensate, returning your blood to a normal pH balance. Acute respiratory acidosis comes on suddenly, leaving the kidneys no time to adjust. Those with chronic respiratory acidosis may experience acute respiratory acidosis due to another illness that causes the condition to worsen. Diagnosis of respiratory acidosis A complete physical examination Continue reading >>
Acidosis
When your body fluids contain too much acid, it’s known as acidosis. Acidosis occurs when your kidneys and lungs can’t keep your body’s pH in balance. Many of the body’s processes produce acid. Your lungs and kidneys can usually compensate for slight pH imbalances, but problems with these organs can lead to excess acid accumulating in your body. The acidity of your blood is measured by determining its pH. A lower pH means that your blood is more acidic, while a higher pH means that your blood is more basic. The pH of your blood should be around 7.4. According to the American Association for Clinical Chemistry (AACC), acidosis is characterized by a pH of 7.35 or lower. Alkalosis is characterized by a pH level of 7.45 or higher. While seemingly slight, these numerical differences can be serious. Acidosis can lead to numerous health issues, and it can even be life-threatening. There are two types of acidosis, each with various causes. The type of acidosis is categorized as either respiratory acidosis or metabolic acidosis, depending on the primary cause of your acidosis. Respiratory acidosis Respiratory acidosis occurs when too much CO2 builds up in the body. Normally, the lungs remove CO2 while you breathe. However, sometimes your body can’t get rid of enough CO2. This may happen due to: chronic airway conditions, like asthma injury to the chest obesity, which can make breathing difficult sedative misuse deformed chest structure Metabolic acidosis Metabolic acidosis starts in the kidneys instead of the lungs. It occurs when they can’t eliminate enough acid or when they get rid of too much base. There are three major forms of metabolic acidosis: Diabetic acidosis occurs in people with diabetes that’s poorly controlled. If your body lacks enough insulin, keton Continue reading >>
Respiratory Acidosis
LABORATORY TESTS The following lab tests can be used to interpret and explain acidosis and alkalosis conditions. All are measured on blood samples. 1. pH: This measures hydrogen ions - Normal pH = 7.35-7.45 2. pCO2= Partial Pressure of Carbon Dioxide: Although this is a pressure measurement, it relates to the concentration of GASEOUS CO2 in the blood. A high pCO2 may indicate acidosis. A low pCO2 may indicate alkalosis. 3. HCO3- = Bicarbonate: This measures the concentration of HCO3- ion only. High values may indicate alkalosis since bicarbonate is a base. Low values may indicate acidosis. 4. CO2 = Carbon Dioxide Content: This is a measure of ALL CO2 liberated on adding acid to blood plasma. This measure both carbon dioxide dissolved and bicarbonate ions and is an older test. Do not confuse with pCO2 Typically, dissolved carbon dioxide = l.2-2.0 mmoles/L and HCO3- = 22-28 mmoles/L Therefore, although it is listed as CO2 content, the lab test really reflects HCO3- concentration. Respiratory Acidosis .ABNORMAL pH IN THE BODY: ACIDOSIS AND ALKALOSIS: INTRODUCTION: Normal blood pH is maintained between 7.35 and 7.45 by the regulatory systems. The lungs regulate the amount of carbon dioxide in the blood and the kidneys regulate the bicarbonate. When the pH decreases to below 7.35 an acidosis condition is present. Acidosis means that the hydrogen ions are increased and that pH and bicarbonate ions are decreased. A greater number of hydrogen ions are present in the blood than can be absorbed by the buffer systems. Alkalosis results when the pH is above 7.45. This condition results when the buffer base (bicarbonate ions) is greater than normal and the concentration of hydrogen ions are decreased. Both acidosis and alkalosis can be of two different types: respiratory and metabol Continue reading >>
Respiratory Acidosis: Causes, Symptoms, And Treatment
Respiratory acidosis develops when air exhaled out of the lungs does not adequately exchange the carbon dioxide formed in the body for the inhaled oxygen in air. There are many conditions or situations that may lead to this. One of the conditions that can reduce the ability to adequately exhale carbon dioxide (CO2) is chronic obstructive pulmonary disease or COPD. CO2 that is not exhaled can shift the normal balance of acids and bases in the body toward acidic. The CO2 mixes with water in the body to form carbonic acid. With chronic respiratory acidosis, the body partially makes up for the retained CO2 and maintains acid-base balance near normal. The body's main response is an increase in excretion of carbonic acid and retention of bicarbonate base in the kidneys. Medical treatment for chronic respiratory acidosis is mainly treatment of the underlying illness which has hindered breathing. Treatment may also be applied to improve breathing directly. Respiratory acidosis can also be acute rather than chronic, developing suddenly from respiratory failure. Emergency medical treatment is required for acute respiratory acidosis to: Regain healthful respiration Restore acid-base balance Treat the causes of the respiratory failure Here are some key points about respiratory acidosis. More detail and supporting information is in the main article. Respiratory acidosis develops when decreased breathing fails to get rid of CO2 formed in the body adequately The pH of blood, as a measure of acid-base balance, is maintained near normal in chronic respiratory acidosis by compensating responses in the body mainly in the kidney Acute respiratory acidosis requires emergency treatment Tipping acid-base balance to acidosis When acid levels in the body are in balance with the base levels in t Continue reading >>
Co2, Blood Ph And Respiratory Alkalosis: Causes And Effects
Blood pH is tightly regulated by a system of buffers that continuously maintain it in a normal range of 7.35 to 7.45 (slightly alkaline). Blood pH drop below 7 can lead to a coma and even death due to severe acidosis. This causes depression of the central nervous system. High blood pH (above 7.45) is called alkalosis. Severe alkalosis (when blood pH is more than 8) can also lead to death, as it often happens during last days or hours of life in most people who are chronically and terminally ill. Hyperventilation is the most common cause of respiratory alkalosis. Note that overbreathing is exceptionally common in people with chronic diseases (for clinical studies, see the Homepage of this site). The main mechanisms for blood pH maintenance and control - Carbonic Acid-Bicarbonate Buffer System - Protein Buffer System - Phosphate Buffer System - Elimination of Hydrogen Ions via Kidneys Carbon dioxide plays one of the central roles in respiratory alkalosis. Note, however, that tissue hypoxia due to critically-low carbon dioxide level in the alveoli is usually the main life-threatening factor in the severely sick. As we discussed before, CO2 is crucial for vasodilation and the Bohr effect. Respiratory alkalosis caused by low CO2 in the arterial blood This YouTube video clip "Hypocapnia, Respiratory Alkalosis: Key Causes of Deaths In the Most Sick" summarizes numerous epidemiological studies related to ineffective breathing in the severely sick and critically ill people. Their breathing is very fast and deep, while oxygenation of cells is critical. This is the reason why, regardless of the health condition, critically ill patients are often provided with pure oxygen. You can read all these medical abstracts on the web page How do we breathe when we die? Many people believe th Continue reading >>
Metabolic And Respiratory Acidosis And Alkalosis
There are two main types of pH imbalances in the body: acidosis and alkalosis. An increase in H+ ion levels in the blood causes pH levels to fall resulting in acidosis. A decrease in H+ levels causes pH levels to rise, making the blood more basic, or alkaline. These conditions can be caused by two kinds of disturbances to the buffers that control the body’s pH levels, which alter the acid-base balance. Metabolic and respiratory acidosis and alkalosis are the results of disruptions to the bicarbonate and carbonic acid components of the chemical buffers. Metabolic and respiratory acidosis result when pH levels fall due to an increase in H+ ions or a loss of bases causing the bodily fluids to become slightly acidic. Insufficient bicarbonate levels lower the pH levels of fluids in the digestive tract, resulting in metabolic acidosis. Respiratory acidosis is caused by excessive carbonic acid in the respiratory system, which lowers pH levels through the retention of CO2. Alkalosis is the result of opposite changes to the acid-base balance: excessive bicarbonate levels in the digestive system increases pH as H+ ion concentrations decrease, which causes fluids to become more basic. Insufficient carbonic acid levels are caused by excessive exhalation of CO2, resulting in respiratory alkalosis. Treatment for metabolic and respiratory acidosis and alkalosis varies depending on the underlying cause of the imbalance. Respiratory acidosis caused by hypoventilation can be treated with oxygen therapy and the help of breathing machines to help restore normal oxygen/carbon dioxide exchange, allowing the kidneys time to increase production of bicarbonate and reestablish the acid-base balance of the blood. Respiratory alkalosis caused by hyperventilation can be treated with inhalation of Continue reading >>
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Blood Gas Analysis--insight Into The Acid-base Status Of The Patient
Acid-Base Physiology Buffers H+ A- HCO3- CO2 Buffers H+ A- CO2 Cells Blood Kidney Lungs Fluids, Electrolytes, and Acid-Base Status in Critical Illness Blood Gas Analysis--Insight into the Acid-Base status of the Patient The blood gas consists of pH-negative log of the Hydrogen ion concentration: -log[H+]. (also, pH=pK+log [HCO3]/ 0.03 x pCO2). The pH is always a product of two components, respiratory and metabolic, and the metabolic component is judged, calculated, or computed by allowing for the effect of the pCO2, ie, any change in the pH unexplained by the pCO2 indicates a metabolic abnormality. CO +H 0ºº H CO ººHCO + H2 2 2 3 3 - + CO2 and water form carbonic acid or H2CO3, which is in equilibrium with bicarbonate (HCO3-)and hydrogen ions (H+). A change in the concentration of the reactants on either side of the equation affects the subsequent direction of the reaction. For example, an increase in CO2 will result in increased carbonic acid formation (H2CO3) which leads to an increase in both HCO3- and H+ (\pH). Normally, at pH 7.4, a ratio of one part carbonic acid to twenty parts bicarbonate is present in the extracellular fluid [HCO3-/H2CO3]=20. A change in the ratio will affect the pH of the fluid. If both components change (ie, with chronic compensation), the pH may be normal, but the other components will not. pCO -partial pressure of carbon dioxide. Hypoventilation or hyperventilation (ie, minute2 ventilation--tidal volume x respitatory rate--imperfectly matched to physiologic demands) will lead to elevation or depression, respectively, in the pCO2. V/Q (ventilation/perfusion) mismatch does not usually lead to abnormalities in PCO2 because of the linear nature of the CO2 elimination curve (ie, good lung units can make up for bad lung units). Diffus Continue reading >>
A Delicate Balance: Understanding Acid-base Issues In Ems Patients
The human body has tremendous capacity to maintain internal balance, or homeostasis, in serious, prolonged situations. However, there are several situations in which an imbalance that is left uncorrected can cause serious harm. EMS providers are trained to recognize that a lack of oxygen or glucose will cause the patient to deteriorate in short order. While harder to detect in the field, derangements in the body's acid-base balance can also be catastrophic. However, a basic understanding of this critical concept can help develop a working field diagnosis and promote early interventions that could reduce morbidity. What are acids and bases? Like all organisms, humans live within a water-based environment. Water contains hydrogen and oxygen (H20). Water freely separates, or dissociates, into positively charged hydrogen ions (H+) and negatively charged hydroxide ions (OH-). Hydrogen ions are a weak acid that interacts with a variety of chemical processes. The number of hydrogen ions within a water solution is expressed through a measurement called the power of hydrogen, or pH. pH is measured using a negative logarithmic scale. This means two things. First, the smaller the pH number, the greater the concentration of hydrogen ions. Second, a change in whole number represents a tenfold change in the number of hydrogen ions. Taking those two concepts together, a fluid with a pH value of 5 is 10 times more acidic than a pH of 6; a pH value of 4 is 100 times more acidic than a pH of 6 (10x10). The range of pH is 1 to 14. Water itself is neutral with a value of 7. A pH number less than 7 is considered acidic, while a number above 7 is considered basic. The human body rests in a slightly basic environment, functioning within a range of 7.35 to 7.45. Acid-base balance within the bo Continue reading >>
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