Acid-base Imbalance

An acid base imbalance occurs when the body fails to maintain the narrow balance between acids and bases. This imbalance can impair essential metabolic processes like functioning of enzymes, oxygen transport and removal of wastes.

Ok. So the measurement of acids and bases is called the PH.

On the PH scale. 7.0 is considered neutral levels above 7.0 are alkalotic or basic and levels below 7.0 are acidotic.

The normal range for Ph in the blood, for adults is 7.35 to 7.45. The main molecules involved in acid base balance are hydrogen bicarbonate, partial pressure of carbon dioxide and partial pressure of oxygen.

Hydrogen has an inverse relationship with the Ph of body fluids. So when there's more hydrogen, the Ph decreases and becomes more acidic.

Whereas when there's less hydrogen, the PH increases, mixed bicarbonate is a basic substance. So when there's more bicarbonate, the PH H increases and body fluids become more alkalotic.

Likewise, when there's less bicarbonate, the Ph decreases and body fluids become more acidotic, then there's partial pressure of carbon dioxide which reflects the amount of acidic carbon dioxide dissolved in the arterial blood and partial pressure of oxygen which reflects the amount of oxygen dissolved in the arterial blood.

Now, acid base balance is regulated by various mechanisms in the body. The cellular buffering system located in the extra and intracellular fluid compartments is able to rapidly absorb excessive acidic and basic ions to minimize ph fluctuations.

Also, the respiratory system controls ph through adjusting carbon dioxide amounts by changing the rate and depth of breathing.

And the renal system manages the amount of excreted and reabsorbed bicarbonate by the kidneys. All right.

Now, acid base imbalances occur when the PH is outside the normal range. These imbalances are categorized as either acidotic or alkalotic depending on the Ph level and metabolic or respiratory, depending on the cause of the imbalance.

The four primary types of acid base imbalance are metabolic acidosis, respiratory acidosis, metabolic alkalosis and respiratory alkalosis.

Starting with metabolic acidosis. This generally refers to a buildup of acid which can happen due to conditions like diabetic ketoacidosis or DKA where the breakdown of fatty acids from hyperglycemia leads to increased acid production.

It can also happen when too much acid is ingested through substances like salicylates such as aspirin or ethyleneglycol, which is used in automotive antifreeze solutions.

It can also occur when the body is unable to excrete acids as seen in kidney disease or from bicarbonate loss from the gi tract like with excessive diarrhea.

Now, to compensate the respiratory system will increase respirations to blow off extra carbon dioxide and begin to eliminate the extra acid.

Next is respiratory acidosis which occurs when the lungs can't eliminate excess carbon dioxide conditions that can cause respiratory acidosis are those that impact gas exchange such as chronic Obstructive Pulmonary disease or CO PD.

Chest trauma that weakens respiratory muscles, brainstem trauma or over sedation. As the carbon dioxide rises, it binds to water forming carbonic acid which dissociates into hydrogen and bicarbonate over time.

The build up of hydrogen leads to the PH to decrease, resulting in acidosis compensation for respiratory acidosis is managed by the kidneys through acid excretion and reabsorption of bicarbonate to offset acid from the hydrogen.

Then there's metabolic alkalosis where the PH rises due to either the loss of hydrogen through excessive vomiting, diarrhea, or gastric suctioning or increased intake of bicarbonate such as with antacid medications.

Now, similar to metabolic acidosis compensation mainly involves the respiratory system which works to decrease the rate and depth of breathing.

As a result, less carbon dioxide exits the body and ph decreases. Lastly, respiratory alkalosis occurs when there's a decrease in the amount of carbon dioxide leading to an increase in ph.

So, unlike respiratory acidosis, it's caused by hyperventilation rather than hypoventilation leading to excessive carbon dioxide loss during breathing.

Respiratory alkalosis can occur in conditions that increase respiratory rate such as hypoxemia, panic disorders, fever or salicylate intoxication.

Now, similar to respiratory acidosis, the renal system compensates by increasing the urinary excretion of bicarbonate while also limiting bicarbonate reabsorption, eventually lowering.

Ph. All right, clinical manifestations of acid base imbalance depend on the type and severity of the disturbance in metabolic acidosis.

The respiratory system works to compensate for increased acidity by eliminating carbon dioxide through exhalation, leading to deep rapid breathing called c small respirations.

Other symptoms include nausea, vomiting and anorexia as well as headache and lethargy which can progress to altered cognition and coma.

Next In respiratory acidosis, headache, blurred vision and restlessness are followed by lethargy, tremors, seizures and eventually coma.

In chronic respiratory acidosis, like in co PD, myocardial depression, hypotension and dysrhythmias may also occur. Now in metabolic alkalosis respirations become slow and shallow to retain carbon dioxide.

Other common symptoms include muscle cramping, weakness, hyperactive reflexes and numbness and tingling in the fingertips and around the mouth.

Eventually seizures, tetany and arrhythmias may also develop lastly, symptoms of respiratory alkalosis are typically related to decreased carbon dioxide including dizziness, paresthesia, and seizures as well as feelings of fear, anxiety and a sense of impending doom.

All right. As a quick recap, acid base imbalances occur when the body's PH levels are disturbed, becoming either acidotic or alkalotic.

The four primary types of acid base imbalances include metabolic acidosis, respiratory acidosis, metabolic alkalosis and respiratory alkalosis.

When these occur. Compensatory mechanisms involving the lungs.

Kidneys and cellular buffer systems aim to restore normal ph within the normal range of 7.35 to 7.45.