Acid Base Balance pH = -log[H+]

Introduction pKa (6.1)

Acid yield H+ -log of the ionization constant

Base yield OH- Protonated and unprotonated forms
Buffer weak acid or weak base + salt are in equal concentration
Henderson Hasselbalch Equation

Buffer system
A
Bicarbonate carbonic acid
o Major extracellular blood pH = pKa + log

buffer (20:1)
Plasma CHONs HCO3
o Surface charges
Hemoglobin pH = pK + log (base)
o Off load O2, combine w/

CO2
o 1g Hgb = 1.39mL O2 > 1
[ HCO 3]
mole of Hgb = 1 mole of O2 pH = 6.1 + log [ 0.03 ] [ pCO 3]
Inorganic Phosphate (iPO4)
o Major composition of cell
membrane
Alterations to H+ Ion Balance
Regulation
Metabolic acidosis
Lungs
o Regulates CO2 concentration Metabolic alkalosis
Kidneys Respiratory acidosis
o HCO3 Respiratory alkalosis
o Acid excretion (NH4+)
Parameters of Acid-Base Balance
pH
pCO2
HCO3
pO2
 Abnormal Conditions Glycolysis = pCO2
Liquid lithium heparin = dilutional
effect
Trapped air, clotted blood
Blood gas analysis = always STAT
Acid Base
pH 7.35 7.45
pCO2 45 35 Other methods:
HCO3 22 26 Gasometer
o Van Slyke
Oxygen and Gas Exchange o Natelson
Hg = vacuum
Parameters of Assessment: Caprylic alcohol = anti-
foam rgt
SO2 = O2 saturation
Lactic acid
FO2Hb = fractional O2 Hb
NaOH and NaHSO3
SpO2 = O2 saturation trend
Electrodes
pO2 = partial pressure of O2
o pH (potentiometry)
REFERENCE METHOD =
Ag-AgCl electrode
Methods: calomel electrode
Pulse oximetry (Hg2Cl2)
o Dont measure metHgb and Common = glass
carboxy Hgb electrode
Co-oximeter o pCO2 (potentiometry)
o O2 saturation (GOLD Severinghaus electrode
STANDARD)
o 4 wavelengths: oxyHgb,
deoxyHgb, metHgb,
carboxyHgb
Lab diagnosis
Specimen: Heparinized arterial blood
(Powdered Lithium heparin)
Sites: radical, brachial, femoral
artery
Modified Allen Test: screening test
Arterial puncture
Specimen considerations

Left at RT = pH & pO2; pCo2

Chilled sample to prevent O2
consumption by RBCs o pO2 (polarography
Excess heparin = pH amperometry)
clark electrode