Lectures on respiratory physiology

Acid-Base Balance
 Some definitions
• An acid is a molecule that releases
hydrogen ions in solution

• A base is a molecule that can accept a

hydrogen ion

• A buffer is a substance that can

reversibly bind hydrogen ions
Titration curve for the bicarbonate buffer system
 Law of Mass Action
CA
CO2 + H2O H2CO3 -
H+ + HCO3
AT EQUILIBRIUM,
-
K = [H+]x [HCO3 ]
[H2CO3]

-
= [H+]x [HCO3 ]
SOLUBILITY x PCO2
 + -
K = [H ] x [HCO3 ]
0.03 x PCO2

WHICH, AFTER TAKING LOGS, BECOMES:

-
pH = pK + Log( [HCO3 ] )
0.03 x PCO2
- THE HENDERSON - HASSELBALCH EQUATION
Derivation of normal pH
Davenport Diagram
 [HCO3-]
pH = 6.1 + Log( )
1.2
PLASMA [HCO3-], meq/l 50

40 PCO2 = 40
30
24
NORMAL
20

10

7.40
0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
PLASMA [HCO3-], meq/l 50

40
10080
PCO2: 60
40
30
30
20 20
10
10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 [HCO3-]
pH = pK + Log( )
0.03 x PCO2
PLASMA [HCO3-], meq/l
50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
ACID - BASE DISTURBANCES:

* RESPIRATORY ACIDOSIS

* RESPIRATORY ALKALOSIS
* METABOLIC ACIDOSIS
* METABOLIC ALKALOSIS
 RESPIRATORY ACIDOSIS:

-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 RESPIRATORY ACIDOSIS:

-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 RESPIRATORY ACIDOSIS:

-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 RESPIRATORY ALKALOSIS:

-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 RESPIRATORY ALKALOSIS:

-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 METABOLIC ACIDOSIS:
-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 METABOLIC ACIDOSIS:
-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER
40 40
LINE 20
30
N
20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 METABOLIC ALKALOSIS
-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER 40
40
LINE 20
30

20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
 METABOLIC ALKALOSIS
-
H+ + HCO3 CO2 + H2O
PLASMA [HCO3-], meq/l 50
80
BUFFER 40
40
LINE 20
30

20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
COMPENSATED RESPIRATORY ACIDOSIS
COMPENSATED METABOLIC ALKALOSIS
PLASMA [HCO3-], meq/l
50
80
BUFFER 40
40
LINE 20
30

20

10

0
6.8 7.0 7.2 7.4 7.6 7.8 8.0

pH
Oxygen Delivery to Tissues
 VENTILATION
LUNGS

DIFFUSION
CAPILLARIES

HEART AND PERFUSION

CIRCULATION

CAPILLARIES
DIFFUSION
TISSUE

THE OXYGEN TRANSPORT SYSTEM

Fick equation for diffusion through a tissue sheet
Distribution of PO2 between capillaries
Critical PO2 for mitochondrial respiration
Classification of tissue hypoxia:

* Hypoxic hypoxia
* Anemic hypoxia
* Circulatory hypoxia
* Histotoxic hypoxia