Fluid, Electrolyte & Acid-

Base Balance
Body Fluids
 Your body is 66% water
 Not evenly distributed – separated into
compartments
 Able to move back and forth through the
cell membranes to maintain an
equilibrium
Fluid Compartments
 Intracellular fluid – fluid inside cells [ICF]
 Extracellular fluid – fluid outside cells
and all other body fluids --- ¼ is plasma
[intravascular fluid], remaining ¾ is
interstitial fluid. Small amount is
localized as CSF, serous fluid, synovial
fluid, humors of eye & endo/perilymph of
ears
Edema
 Condition in which fluid accumulates in
the interstitial compartment. Sometimes
due to blockage of lymphatic vessels or
by a lack of plasma proteins or sodium
retention
Fluid Balance
 Amount in = amount out
 Average daily intake is 2500 ml [ fluids,
food and metabolic water]
 Average daily output is 2500 ml [ urine,
feces, perspiration, insensible
perspiration]
 What can throw off these numbers?
Electrolyte Balance
 Definition: - concentration of individual
electrolytes in the body fluid compartments
is normal and remains relatively constant.
 Electrolytes are dissolved in body fluids
 Sodium predominant extracellular cation,
and chloride is predominant extracellular
anion. Bicarbonate also in extracellular
spaces
Electrolyte Balance
 Potassium is the predominant
intracellular cation and phosphates are
the predominant intracellular anion
 Cations are actively reabsorbed, anions
passively follow by electrochemical
attraction
 Aldosterone works at kidney tubules to
regulate sodium & potassium levels
Electrolyte Balance
 Because of sodium and potassium
influence, water will move between
compartments
 Example: if high [sodium], then water
will move from intracellular space to
extracellular space due to osmotic
pressure
Balance of other Electrolytes
 Calcium – hypercalcemia / hypocalcemia
 Magnesium – hypermagnesemia/
hypomagnesemia
 Phosphate – hyperphosphatemia/
hypophosphatemia
 Chloride – hyperchloremia/
hypochloremia
Acid - Base Balance
 Blood - normal pH of 7.2 – 7.45
 < 7.2 = acidosis > 7.45 = alkalosis
 3 systems to maintain normal blood pH
1. Buffers
2. Removal of CO2 by lungs
3. Removal of H+ ions by kidneys
Buffers
 Protein Buffer Systems
 Amino Acid buffers
 Hemoglobin buffers
 Plasma Protein buffers
 Phosphate Buffer Systems
 Carbonic Acid – Bicarbonate Buffer
System
Maintenance of Acid-Base
Balance
 Respiratory System: removal of CO2 by
lungs – stabilizes the ECF, has direct
effect on Carbonic Acid – Bicarbonate
Buffer System

 Urinary System: removal of H+ ions by

kidneys
Disturbances to Acid-Base
Balance
 Respiratory Acidosis
 Respiratory Alkalosis
 Metabolic Acidosis [ lactic acidosis,
ketoacidosis]
 Metabolic Alkalosis
www.nda.ox.ac.uk/ wfsa/html/u13/u1312_02.htm