Acid Base Balance
Acid Base Balance Chapter Overview
Jennifer Kong
Chapter Learning Objectives
By the end of this chapter, you will be able to:
- Define acidosis and alkalosis.
- Interpret the cause of pH disturbance as respiratory, metabolic, or mixed using blood tests – especially blood gases and chemistry.
- Calculate anion gaps to further differentiate causes metabolic acidosis.
- Compare and contrast clinical manifestations of acidosis and alkalosis.
- Identify compensatory mechanisms during acid base disturbances.
- List treatment and management of acute acid base disorders.
Acid Base Balance Overview
The body’s fluids are a soup of proteins, electrolytes, lipids, acids, and various other molecules. Each of these molecules exist in chemical equilibria with each other based on their construction and various charges. They attract and react with each other, push each other away, bend and change the shape of each other. There is an ideal concentration of all these chemicals in the chemical soup of our bodies that ensures that body systems, and our metabolisms, function properly. pH is a measure of proton activity in a fluid, and the body maintains a pH of between 7.35 and 7.45.
Normal pH is ideal for blood oxygen binding, hemoglobin is folded into the most ideal quaternary structure for O2 binding at this pH. Many of the complex molecules involved in cell physiology and metabolism become charged or ionized at a neutral pH of 7, which decreases their ability to be used for particular reactions efficiently. When the pH shifts to a relative alkalotic or acidotic state it has a cascade of effects on various body systems which will be touched on in this chapter.
This chapter will be primarily focused acid base imbalances, and will be broken into the following sections:
- Pretest
- Review of pH, acids, bases, and the body’s buffer systems
- Acid base disorders and compensatory mechanisms
- Metabolic Acidosis and the Anion Gap
- Metabolic Alkalosis
- Respiratory Acidosis
- Respiratory Alkalosis
- Diagnosis of Acid Base Disorders with case studies
- Management and treatment of acid base disorders
- Post-test
Abbreviations
The following abbreviations are used throughout the chapter.
| AG | Anion Gap |
| HAGMA | High Anion Gap Metabolic Acidosis |
| NAGMA | Non Anion Gap Metabolic Acidosis |
| VBG | Venous Blood Gases |
