Acid-Base Balance Health Article

Definition

Acid-base balance can be defined as homeostasis of the body fluids at a normal arterial blood pH ranging between 7.37 and 7.43.

Description

An acid is a substance that acts as a proton donor. In contrast, a base, also known as an alkali, is frequently defined as a substance that combines with a proton to form a chemical bond. Acid solutions have a sour taste and produce a burning sensation with skin contact. A base is any chemical compound that produces hydroxide ions when dissolved in water. Base solutions have a bitter taste and a slippery feel. Despite variations in metabolism, diet, and environmental factors, the body's acid-base balance, fluid volume, and electrolyte concentration are maintained within a narrow range.

Function

Many naturally occurring acids are necessary for life. For example, hydrochloric acid is secreted by the stomach to assist with digestion. The chemical composition of food in the diet can have an effect on the body's acid-base production. Components that affect acid-base balance include protein, chloride, phosphorus, sodium, potassium, calcium, and magnesium. In addition, the rate at which nutrients are absorbed in the intestine will alter acid-base balance.

Cells and body fluids contain acid-base buffers, which help prevent rapid changes in body fluid pH over short periods of time, until the kidneys pulmonary systems can make appropriate adjustments. The kidneys and pulmonary system then work to maintain acid-base balance through excretion in the urine or respiration. The partial pressure of carbon dioxide gas (PCO₂) in the pulmonary system can be measured with a blood sample and correlates with blood carbon dioxide (CO₂) levels. PCO₂ can then be used as an indicator of the concentration of acid in the body. The concentration of base in the body can be determined by measuring plasma bicarbonate (HCO_3-) concentration. When the acid-base balance is disturbed, the respiratory system can alter PCO₂ quickly, thus changing the blood pH and correcting imbalances. Excess acid or base is then excreted in the urine by the renal system to control plasma bicarbonate concentration. Changes in respiration occur primarily in minutes to hours, while renal function works to alter blood pH within several days.

Role in human health

Production of CO₂ is a result of normal body metabolism. Exercise or serious infections will increase the production of CO₂ through increased respiration in the lungs. When oxygen (O₂) is inhaled and CO₂ is exhaled, the blood transports these gases to the lungs and body tissues. The body's metabolism produces acids that are buffered and then excreted by the lungs and kidneys to maintain body fluids at a neutral pH. Disruptions in CO₂ levels and HCO₃-create acid-base imbalances. When acid-base imbalances occur, the disturbances can be broadly divided into either acidosis (excess acid) or alkalosis (excess base/alkali).

Common diseases and disorders

Acid-base metabolism imbalances are often characterized in terms of the HCO₃-/CO₂ buffer system. Acid-base imbalances result primarily from metabolic or respiratory failures. An increase in HCO₃-is called metabolic alkalosis, while a decrease in the same substance is called metabolic acidosis. An increase in PCO₂, on the other hand, is known as respiratory acidosis, and a decrease in the same substance is called respiratory alkalosis.

Acidosis

Acidosis is a condition resulting from higher than normal acid levels in the body fluids. It is not a disease, but may be an indicator of disease. Metabolic acidosis is related to processes that transform food into energy and body tissues. Conditions such as diabetes, kidney failure, severe diarrhea, and poisoning can result in metabolic acidosis. Mild acidosis is often compensated by the body in a number of ways. However, prolonged acidosis can result in heavy or rapid breathing, weakness, and headache. Acidemia (arterial pH < 7.35) is an accumulation of acids in the bloodstream that may occur with severe acidosis when the acid load exceeds respiratory capacity. This condition can sometimes result in comaand, if the pH falls below 6.80, it will lead to death. Diabetic ketoacidosis is a condition where excessive glucagon and a lack of insulin contribute to the production of ketoacids in the liver. This condition can be caused by chronic alcoholism and poor carbohydrate utilization.

Respiratory acidosis is caused by the lungs's failure to remove excess carbon dioxide from the body, reducing

the pH in the body. Several conditions, including chest injury, blockage of the upper air passages, and severe lung disease, may lead to respiratory acidosis. Blockage of the air passages may be caused by bronchitis, asthma, or airway obstruction, resulting in mild or severe acidosis. Regular, consistent retention of carbon dioxide in the lungs is referred to as chronic respiratory acidosis. This disorder results in only mild acidosis because it is balanced by increased bicarbonate production.

The predominant symptoms of acidosis are sometimes difficult to distinguish from symptoms of an underlying disease or disorder. Mild conditions of acidosis may be asymptomatic or may be accompanied by weakness or listlessness, nausea, and vomiting. Most often, severe metabolic acidosis (pH < 7.20) is associated with increased respiration to compensate for a shortage of HCO₃-. This is followed by a secondary decrease in PCO₂ that occurs as part of respiratory compensation process. Treatment options for acidosis typically require correction of the underlying condition by venous administration of sodium bicarbonate or another alkaline substance.