Pathophysiology of Acid Base Balance Essay

6963 Words Jan 22nd, 2012 28 Pages
Intensive and Critical Care Nursing (2008) 24, 28—40


Pathophysiology of acid base balance: The theory practice relationship
Sharon L. Edwards ∗
Buckinghamshire Chilterns University College, Chalfont Campus, Newland Park, Gorelands Lane, Chalfont St. Giles, Buckinghamshire HP8 4AD, United Kingdom
Accepted 13 May 2007

Acid base balance; Arterial blood gases; Acidosis; Alkalosis

Summary There are many disorders/diseases that lead to changes in acid base balance. These conditions are not rare or uncommon in clinical practice, but everyday occurrences on the ward or in critical care. Conditions such as asthma, chronic obstructive pulmonary disease (bronchitis or emphasaemia), diabetic ketoacidosis,
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In contrast, a reduction

Table 2

Chemical abbreviations Interpretation Oxygen Carbon dioxide Kilo pascals Partial pressure of oxygen Partial pressure of carbon dioxide Hydrogen ions Bicarbonate ions Carbonic acid Sodium Potassium Chloride Ammonium

Abbreviation O2 CO2 kPa PO2 PCO2 H+ HCO3 − H2 CO3 Na+ K+ Cl− NH4 +

30 in PO2 is monitored by the peripheral chemoreceptors located in the corotid and aortic bodies which transmit nervous signals to the respiratory centre in the medulla for control of respiration (Schlichtig et al., 1998; Williams, 1998). However, it is the CO2 ‘drive’ for breathing that dominates in health, although the O2 ‘drive’ can be significant in some disordered states as an adaptation to chronic evaluations of PC02 for example in chronic obstruction lung conditions.

S.L. Edwards blood cells) and breaks down into CO2 and water (H2 O) (Fig. 1). The CO2 /HCO3 − interaction is slow in plasma, but quicker in red blood cells due to the presence of carbonic anhydrase.

Respiratory disorders
Acid base disorders resulting from primary alterations in the PCO2 are termed respiratory disorders. Any increase in concentration or retention of CO2 (considered a volatile source of acid which evaporates rapidly in body fluids) i.e. production > excretion will produce an increase in H+ through the

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