Blood Gases, pH, and Buffer

system
Part 1
 Introduction
• Acid: substances that yields H ions or
hydronium in H2O.
• Base: yields a hydroxyl ion (OH).
• Substance ability to dissociate is based on
strength of acids and base (ionizaton
constant-K value)

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 Introduction
• Acid: have a larger K value: greater
ability to dissociate into ions in H2O
• pK: defined as the negative log of the
ionization constant; that is pH where the
protonated and unprotonated forms are
present in equal concentration.

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 Strong acids vs. Strong Base
• Strong acids: have pK value of less than
3.0
• Strong base: have a pK value greater than
9.0
• Buffer: a combination of weak acid or
weak base and its salt

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 Acid-Base balance
• Maintenance of hydrogen ions:
• Body produces 40-80 mmol of H/day,
• normal concentration of H in ECF ranges from
36-44 nmol of hydrogen ion.
• Any deviation from the values the body will try to
compensate.
• >44 nmol/L: altered consciousness, coma- death
• <36 nmol/L: neuromuscular irritability, tetany,
loss of consciousness- death.

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Concentration of H ions and pH

• Reciprocal relationship in the

concentration of H ions and pH
• Increase pH: decrease in H ion
• Decrease pH: increase H ions
• Arterial blood pH is controlled by:
1. Buffers
2. Respiratory System
3. Kidneys

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Buffer System: Regulation of H +

• First line of defense to changes in H+ consist of

weak acid (H2CO3) & its salt (HCO3)
• Add acid to the bicarbonate-carbonic acid
system- the HCO3 combines with H from the
acid to form H2CO3.
• Add a base to the system, H2CO3 combines with
OH to form H2O and HCO3
• Keeps the body at the correct pH (7.35-7.45)

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Buffer System: Regulation of H +

• Bicarbonate – carbonic acid system has

low buffering capacity but still an
important buffer system for 3 reasons
1. H2CO3 dissociates into CO2 & H2O allowing H+ to
be eliminated as CO2 by lungs
2. Changes in PCO2 modify the ventilation rate
3. HCO3 conc. can be altered by kidney

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 Other systems
• HPO4–2  H2PO4– system
• proteins are capable of binding H+.
• Hemoglobin

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 Respiratory system
• End product of aerobic metabolic process
is CO2, this diffuses out the tissue into
plasma and RBC.
• It combines with H2O to form H2CO3
(carbonic acid), then dissociates into
hydrogen ions which is buffered by plasma
proteins.

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 RBC regulation
• CO2 and O2 exchange, some CO2 remains
in the RBC in combination to HB
• CO2 combines to water to form carbonic
acid and is transported in the blood.
• Carbonic anhydrase enzymes in the RBC
accelerate this process
(CO2 + H2O→H2CO3(

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 Chloride Shift- (lungs)
• Hydrogen ions dissociate to HCO3
• O2 picked up in the lungs- unloads
oxyhemoglobulin (O2Hb) in tissue.
• Hb accepts hydrogen ion to form
deoxyhemoglobulin.
• HCO3 increases in RBC it will diffuse out
into the plasma, to keep electrically neutral
plasma, chloride diffuses into the cells.

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 Respiratory effects
• Hydrogen ions carried on the
deoxyhemoglobulin in blood circulation
(H2CO3→H2O + CO2)
• CO2 is released in the lungs
• If CO2 cannot be removed sufficiently there is
an increase in hydrogen ions-causes a decrease
in pH.
• If CO2 removed too quickly there is a decrease
in hydrogen ions, causes an increase in pH.

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M. Zaharna Clin. Chem. 2009
 Kidney system
• Main role is by reclaiming bicarbonate
• Kidneys respond to increase or decrease in
hydrogen ions by selectively excreting or
reabsorbing:
1. Hydrogen ions
2. Sodium
3. Chloride
4. Phosphate
5. Ammonia
6. Bicarbonate

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 Reabsorption of Bicarbonate
• Reabsorbing of bicarbonate (HCO3) takes
place in the renal tubule cells.
• Na is exchanged for H ion.
• H ion combines with the HCO3 and carbonic
acid dissociates into H2O and CO2.
• CO2 diffuses into the tubule cells combining
with H2O forming H2CO3.
• Reabsorption of bicarbonate in the blood
system.
• Urinary H+ combines with HPO4– and NH3.
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M. Zaharna Clin. Chem. 2009
 Acid-Base Disorders
• Acidosis (decrease pH) → acidemia
• vs. Alkalosis (increased pH) → alkalemia
• metabolic or respiratory

• Inadequate elimination and excess production of

CO2 in the body.
• Body compensates by respiration rate and
kidney.

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 Acidosis
1. Metabolic (non-respiratory) Acidosis
– Decrease pH, increase H
– Bicarbonate decreased (<24 mmol/L)
– Reduce excretion of acids
– Caused by acid producing substance or process
• Respiratory compensation:
– Hyperventilation, decrease CO2 in circulation.
• Renal compensation:
– increase H ion loss by increasing PO4 and NH4
excretion and retain HCO3
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 Acidosis
2. Respiratory Acidosis:
– caused by hypoventilation (decrease the elimination
of CO2 in the lungs, it builds up in the blood)
– In plasma → increase in CO2 decrease in pH,
increase in H and HCO3
– Diseases: emphysema, drugs , congestive heart
failure, bronchopneumonia.

• Respiratory compensation
– hyperventilation
• Renal compensation
– increase H excretion & increase reabsorption of
HCO3-

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 Alkalosis
1. Metabolic alkalosis:
– pH increased, H decreased, CO2 increased, HCO3
increased.
– Causes of nonrespiratory alkalosis:
– excess administration of Na HCO3–
– ingestion of HCO3– producing salts such as Na-lactate, citrate
or acetate
– excessive loss of acid through vomiting

• Respiratory compensation
– Hypoventilation with CO2 retention
• Renal compensation
– excrete HCO3 and retain H ions.

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 Alkalosis

2. Respiratory alkalosis:
– increased pH, decreased H, decreased
CO2, decreased HCO3.
• Renal compensation
– decrease renal excretion of H ions, HCO3
excreted.
• Respiratory compensation
– increase CO2 by hyperventilation
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