Blood Buffers

Definition
A buffer is defined as a solution or reagent that resists a change in pH with the addition of either an acid or a base It is a mixture of a weak acid or weak base and its salts that resists changes in pH when a strong acid or base is added to the solution. Effectiveness of a buffer depends on
the pK of the buffering system and the pH of the environment in which it is placed

Acid base balance

The normal conc. of H+ in the ECF ranges from 36 to 44 nmol/L(7.34 7.44) metabolism in the body produces large quantities of H+ The body using various mechanisms that involves the lungs and the kidneys controls and excretes H+ to maintain pH.

 The reference value of arterial blood pH is 7.40 equivalent to an H+ conc. of 40 nmol/L. The arterial pH is controlled by systems that regulate the production and retention of acids and bases This include buffers, the respiratory centers and lungs, and the kidneys.

Buffer systems
Bodies first line of defence against extreme changes in H+ concentration is the buffer systems Buffer systems are present in all body fluids All buffers consists of a weak acid, such as carbonic acid (H2CO3), and its salt or conjugate base, bicarbonate(HCO3-)

 Most important buffer system in the plasma is the bicarbonate/carbonic acid pair.

Bicarbonate/carbonic acid buffer system

Its also present inside the RBCs but at a lower conc. The pK value of this buffer system is 6.1

At pH 7.4 the ratio of base to acid is 20:1 The HH equation indicates that at this ratio the pH is 7.4

pH = pKa + [H CO - ] 2 3

[HCO3- ]

or, pH = 6.1 + log 20 = 7.4

 When an acid is added HCO3-/H2CO3 system HCO3- + H+ H2CO3 When a base is added, H2CO3 + OH- H2O + HCO3In both cases there is smaller change in the pH than would result from adding the acid or base to an unbuffered solution

The effectiveness of the buffer system is based on 1) Its present in high concentration (> 20 mmol/L) 2) The lungs can dispose of readily or retain CO2 (as changes in CO2 modify the ventilation rate) 3) The bicarconate (HCO3-) can be readily disposed of or reclaimed by the kidneys. 4) High buffer concentration helps to H+ ions generated by lactate ( 5 mmol/L lactate generates 5 mmol/L H+)

Phosphate buffer system

It consists of dibasic phosphate (HPO42- ) and monobasic phosphate (H2PO4- ) as base and acid member respectively. The concentration of this buffer in both plasma and RBCs is less(accounts for less than 5% of non bicarbonate buffer in the blood)

At pH 7.4 the ratio of base to acid is 4:1, it has a pKa of 6.8

The HH equation indicates that at this ratio the pH is 7.4

pH = pKa +

[HPO42- ] [H2PO ]
4

or, pH = 6.8 + log 4 = 7.4

 Inside RBCs in the form of 2,3-DPG it has a higher buffering action ( it is a significant intracellular buffer)

Plasma protein and hemoglobin buffer system

Plasma proteins especially albumin form important buffer in plasma and intracellular fluids They contribute 95% of non-bicarbonate buffer capacity of plasma Their buffering capacities depend on the pKa of ionisable amino acid groups The most imp. ionisable group of plasma proteins at physiological pH is imidazole group of histidine

 Each albumin has 16 histidine molecules.

Haemoglobin
Hb plays a role in buffering CO2 inside RBCs. Inside cappillaries CO2 enters RBCs & combines with water to give carbonic acid(carbonic anhydrase) Inside RBCs deoxyhemoglobin (Hb-) is formed after deoxygenation Hb- combines with carbonic acid to give HHb and HCO3-

 HCO3- thus formed moves out of RBCs Chloride moves in to maintain electroneutrality. This is called the chloride shift. In the lungs HHb in the lung produces HHbO2 , which ionises into H+ and HbO2 H+ ions combine with HCO3- to form H2CO3 H2CO3 H2O + CO2

 RESPIRATORY AND RENAL MECHANISMS OF ACID BASE BALANCE -

Lungs
Lungs serve to normalise the [HCO3-]/ [H2CO3] Hyperventilation increase the ratio thus increasing pH while hypoventilation decreases the pH. The pulmonary ventilaion is adjusted by the pH of blood

 Fall in blood pH to 7.1 raises the alveolar ventilation to almost 2.5 times the normal value While a rise in blood pH to 7.6 reduces the ventilation to almost half the normal value. Thus acidosis can cause hyperventilation and alkalosis can cause hypoventilation.