- Maintenance of the hydrogen ion concentration within a narrow range is vital for cell survival.
- The acid-base balance is regulated by the concerted action of lungs and kidneys. The erythrocytes play a key role not only in the transport of oxygen, but also in the transport of carbon dioxide in blood.
- The main buffers in blood are hemoglobin and bicarbonate, whereas in the cells they include proteins and phosphate. The bicarbonate buffer system is unique in that it communicates with atmospheric air.
- Acid-base disorders are acidosis and alkalosis and each of them may be either metabolic or respiratory. The determination of pH, pCO2 and bicarbonate, and pO2, is a first line investigation frequently required in emergencies.
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- Describe how does the bicarbonate buffer cope with an addition of acid to the system.
- Discuss bicarbonate handling by the kidney and characterize differences between processes occurring in the proximal and distal renal tubule.
- Outline the role of ventilation in acid-base disorders.
- Which disorders of the acid base balance may be associated with gastrointestinal surgery?
- Discuss the association between acid-base disorders and plasma potassium concentration.
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| Androgue HJ, Madias NE. Management of life-threatening acid-base disorders (first of two parts). N Engl J Med 1998;338:26-34.
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| Androgue HJ, Madias NE. Management of life-threatening acid-base disorders (second of two parts). N Engl J Med 1998;338:107-111.
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| Thomson WST, Adams JF, Cowan RA. Clinical acid-base balance. Oxford: Oxford University Press; 1997.
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| Dominiczak MH, ed. Seminars in clinical biochemistry. Glasgow: University of Glasgow 1997.
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Gluck SE. Electrolyte quintet: Acid-base. Lancet 1998;352:474-79.
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