249
S. Faubel and J. Topf10 Introduction to Acid-Base Physiology
10
10 Introduction to Acid-Base Physiology
250
The Fluid, Electrolyte and Acid-Base Companion
Introduction
Acid-base physiology is not hard.
Acidemia
Acidemia is an increase in plasma hy-drogen concentration above normal.It is recognized by a hydrogen con-centration above 45 nanomol/L or apH below 7.35.
Acidosis
Acidosis is a
process
which increas-es plasma hydrogen concentration.
Acid-base regulation is a subject which is often confusing and intimidat-ing, despite the fact that it is simply the maintenance of a normal hydrogenion concentration.Just as it is important to maintain a consistent concentration of sodium,it is important to maintain a consistent concentration of hydrogen. Like-wise, just as there are defenses to keep the sodium concentration withinnormal limits, there are defenses to keep the hydrogen concentration withinnormal limits.This chapter discusses how hydrogen is measured and how the body de-fends against changes in its concentration.
Acid-base regulation is the maintenance of a normal plasma___________ concentration. Acidemia is a(n) __________ (increase/decrease) in plasma hy-drogen concentration.___________ is a process which decreases plasma hydrogen con-centration.
Alkalemia
Alkalemia is a decrease in plasma hy-drogen concentration below normal.It is recognized by a hydrogen con-centration below 35 nanomol/L or apH above 7.45.
Alkalosis
Alkalosis is a
process
which decreas-es plasma hydrogen concentration.
aaahydrogenincrease Alkalosis
H
+
H
+
251
S. Faubel and J. Topf10 Introduction to Acid-Base Physiology
The normal plasma hydrogen concentration is 40 nanomoles per liter (na-nomol/L) and can normally range between 35 and 45 nanomol/L. The rangeof hydrogen concentration that is compatible with life is between 16 and160 nanomol/L.Note the units: one nanomole is
⁄
₁
₀₀₀
₀₀₀
₀₀₀
of a mole. Remember thatsodium and potassium are measured in millimoles which are
⁄
₁
₀₀₀
of amole. Thus, hydrogen is measured in units which are six orders of magni-tude (a million times) smaller than any other physiologically important ion.Because hydrogen is a univalent ion (has a charge of one), the molar con-centration is equal to the equivalent concentration. For example, 40 nano-mol/L is the same as 40 nanoequivalents/L (nanoEq/L).
Measuring hydrogen
Normal plasma hydrogen concentrationis 40 nanomoles/liter.
Normal _____________ concentration is 40 nanomol/L.Hydrogen concentrations less than 16 or greater than 160nanomol/L are not compatible with __________.75 nanomoles of hydrogen is the same as 75________________ of hydrogen.hydrogenlifenanoequivalents
05015010016nanomol/L40nanomol/L160nanomol/L0.00004 mEq/L
ALKALEMIA ACIDEMIA
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