1. BY : MUHANNAD ALI ASIRI 432800225

2. Acid base balance

3. Acid-base balance refers to the mechanisms in the body uses to keep its fluids close to normal pH (that is, neither basic nor acidic) so that the body can function normally. Arterial blood pH is normally : between 7.35 and 7.45 What is acid base balance

4. Why is acid-base balance important? Because any disturbance in ph range effect on multi system and process in body as : Enzyme systems, oxygenation, muscle, nerve and metabolic functions of the body work best within a specific pH range.

5. Definition of acid-base disorders a change in the normal value of extracellular pH An acid base disorder is a change in the normal value of extracellular pH that may result when renal or respiratory function is abnormal or when an acid or base load overwhelms excretion capacity.

6. Effects of acidosis: 1-depresses CNS 2-decrease plumonary blood flow 3-arrhythmias 4-hyperkalemia Effect of alkalosis : 1- decrease cerbral blood flow 2-seaizures 3-arrhythmias

7. How to recognize abnormal acid- base? normal range Abnormal ph (7.35-7.45) Abnormal Hco 3 (22-24 mEq / L) Abnormal pCO2 ( 35-40 mm Hg) Abnormal anion gap (10-14 mEq / L )

8. REMEMBER HCO3 level indication of METABOLIC problem pCO2 level indication of RESPIRTORY problem

9. Henderson-hasselbach equation [H + ] = 24 × PCO 2 HCO 3 -

10. Relationship between [H + ] & CO 2 & HCO 3 - CO 2 [H + ] CO 2 [H + ] (Positive relationship) HCO 3 - [H + ] HCO 3 - [H + ] (Inverse relationship)

11. Relationship between [H + ] & pH

12. Relationship between [H + ] & CO 2 & HCO 3 - & ph CO 2 [H + ] pH (respiratory acidosis) CO 2 [H + ] pH (respiratory alkalosis) HCO 3 - [H + ] pH (metabolic alkalosis) HCO 3 - [H + ] pH (metabolic acidosis)

13. Some Causes of acid base disturbance (generally) Dm (m a) Shock ( septic,hypovolemic,cardognic) (m a) Renal failure (m a) Vomiting (m al) Diuretics (m al) Asthma (r al) Hyperventilation syndrome (r al) Copd (r a) Myasthenia gravis (r a)

14. Response to acid – base disturbance: H ＋ load ECFlungICFRenalBone Buffers Mainly Hco 3 co 2 Respiratory control Cellular Hpo 4 (weak) H + excretion bicarbonate reabsorption Release bone salt H ＋ － K ＋ exchange Ca 2 ＋ ＋ H 2 PO 4  In chronic metabolic acidosis H 2 CO 3  CO 2 Acid excretion Hyperventilation hyopventilation Immediately minutes hoursdays Very slow

16. Compensatory Mechanisms Compensation is the body’s way of restoring a normal blood pH Compensation DOES NOT treat the root of the problem – the reason for the acid-base imbalance is STILL THERE!!!

17. Simple vs Mixed acid base distrbance Simple When compensation is appropriate Mixed When compensation is inappropriate

18. Remember : If abnormal ph (7.35-7.45) Acidosis or Alkalosis If abnormal Hco3 Metabolic cause If abnormal pCO2 Respiratory cause

19. TYPES METOBLIC ACDOSIS METOBLIC ALKLOSIS RESPIRTORY ACDOSIS RESPIRTORY ALKLOSIS