Acidosis

	Email		Print
	Bookmark		Link

Acidosis

Acidosis is an increased acidity (i.e. an increased hydrogen ion

Hydrogen ion

Hydrogen ion is recommended by IUPAC as a general term for all ions of hydrogen and its isotopes. Depending on the charge of the ion, two different classes can be distinguished:...
concentration

Concentration

In chemistry, concentration is the measure of how much of a given chemical substance there is mixed with another substance. This can apply to any sort of chemical mixture, but most frequently the concept is limited to homogeneous solutions, where it refers to the amount of solute in the solvent....
). If not further qualified, it usually refers to acidity of the blood plasma

Blood plasma

Blood plasma is the liquid component of blood, in which the blood cells are suspended. It makes up about 55% of total blood volume. It is composed of mostly water , and contains dissolved proteins, glucose, clotting factors, mineral ions, Hormone and carbon dioxide ....
.

Acidosis is said to occur when arterial pH

pH is a measure of the Acid or Base of a solution. It is defined as the cologarithm of the Activity of dissolved hydrogen ions . Hydrogen ion activity coefficients cannot be measured experimentally, so they are based on theoretical calculations....
falls below 7.35, while its counterpart (alkalosis

Alkalosis

Alkalosis refers to a condition reducing hydrogen ion concentration of artery blood plasma . Generally alkalosis is said to occur when pH of the blood exceeds 7.45....
) occurs at a pH over 7.45. Arterial blood gas

Arterial blood gas

Discussion

Ask a question about 'Acidosis'

Start a new discussion about 'Acidosis'

Answer questions from other users

Full Discussion Forum

Encyclopedia

Acidosis is an increased acidity (i.e. an increased hydrogen ion

Hydrogen ion

Hydrogen ion is recommended by IUPAC as a general term for all ions of hydrogen and its isotopes. Depending on the charge of the ion, two different classes can be distinguished:...
concentration

Concentration

Blood plasma

Alkalosis

Arterial blood gas

An arterial blood gas is a blood test that is primarily performed using blood from an artery. It involves puncturing an artery with a thin needle and syringe and drawing a small volume of blood....
analysis and other tests are required to separate the main causes.

The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states. Nevertheless, physicians sometimes use the terms interchangeably. The distinction may be relevant where a patient has factors causing both acidosis and alkalosis, where the relative severity of both determines whether the result is a high or a low pH.

The rate of cellular metabolic activity effects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g. healthy human-arterial blood pH varies between 7.35 and 7.45). Blood pH values compatible with life in mammals are limited to a pH range between 6.8 and 7.8. Changes in the pH of arterial blood (and therefore the extracellular fluid) outside this range result in irreversible cell damage.

Respiratory acidosis

Respiratory acidosis is acidosis due to decreased Ventilation of the lung alveoli, leading to elevated artery carbon dioxide concentration ....
results from a build-up of carbon dioxide in the blood (hypercapnia) due to hypoventilation

Hypoventilation

In medicine, hypoventilation occurs when Ventilation is inadequate to perform needed gas exchange. By definition it causes an increased concentration of carbon dioxide and respiratory acidosis....
. It is most often caused by pulmonary

Lung

The lung is the essential respiration organ in air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located in the chest on either side of the heart....
problems, although head injuries

Head injury

Head injury refers to Physical trauma to the head . This may or may not include injury to the human brain . However, the terms traumatic brain injury and head injury are often used interchangeably in the medical literature....
, drugs (especially anaesthetics and sedative

Sedative

A sedative is a substance that induces sedation by reducing irritability or excitement.At higher doses it may result in slurred speech, staggering gait , poor judgment, and slow, uncertain reflexes....
s), and brain tumor

Brain tumor

A brain tumor is an abnormal growth of cells within the brain or inside the skull, which can be cancerous or non-cancerous .It is defined as any cranium tumor created by abnormal and uncontrolled Mitosis, normally either in the brain itself , in the cranial nerves , in the brain envelopes , skull, pituitary and pineal gland, or spread from...
s can cause this acidemia. Pneumothorax

Pneumothorax

In medicine , a pneumothorax, or collapsed lung, is a potential medical emergency caused by accumulation of air or gas in the pleural cavity....
, emphysema

Emphysema

Emphysema is a chronic obstructive pulmonary disease . It is often caused by exposure to toxin Chemical substance, including long-term exposure to tobacco smoking....
, chronic bronchitis

Bronchitis

Bronchitis is an inflammation of the large bronchus in the lungs. It can progress to pneumonia. Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks....
, asthma

Asthma

Asthma is a common chronic obstructive pulmonary disease, in which the Lung constrict, become inflammation, and are lined with excessive amounts of thickened mucus, often in response to one or more triggers....
, severe pneumonia

Pneumonia

Pneumonia is an Inflammation illness of the lung. Frequently, it is described as lung parenchyma/alveolus inflammation and abnormal alveolar filling with fluid ....
, and aspiration

Aspiration pneumonia

Aspiration pneumonia is bronchopneumonia that develops due to the entrance of foreign materials that enter the bronchial tree, usually oral or gastric contents ....
are among the most frequent causes. It can also occur as a compensatory response to chronic metabolic alkalosis

Metabolic alkalosis

Metabolic alkalosis is a metabolic condition in which the pH of the blood is elevated beyond the normal range. This is usually the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations....
.

One key to distinguish between respiratory and metabolic acidosis is that in respiratory acidosis, the CO₂ is increased while the bicarbonate

Bicarbonate

In inorganic chemistry, bicarbonate is an intermediate form in the deprotonation of carbonic acid. Its chemical formula is HCO3−....
is either normal (uncompensated) or increased (compensated). Compensation occurs if respiratory acidosis is present, and a chronic phase is entered with partial buffering of the acidosis through renal bicarbonate retention.

However, in cases where chronic illnesses which compromise pulmonary function persist, such as late-stage emphysema and certain types of muscular dystrophy

Muscular dystrophy

Muscular dystrophy refers to a group of genetics, hereditary muscle diseases that weaken the muscles that move the human body. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cell and biological tissue....
, compensatory mechanisms will be unable to reverse this acidotic condition. As metabolic bicarbonate production becomes exhausted, and extraeneous bicarbonate infusion can no longer reverse the extreme buildup of carbon dioxide associated with uncompensated respiratory acidosis, mechanical ventilation

Mechanical ventilation

In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous respiration .Mechanical ventilation is typically used after an invasive intubation, a procedure wherein an endotracheal tube or tracheostomy tube is inserted into the airway....
will usually be applied.

Metabolic acidosis

In medicine, metabolic acidosis is a process which if unchecked leads to acidemia, i.e. blood pH is low due to increased production of hydrogen by the body or the inability of the body to form bicarbonate in the kidney....
is an increased production of metabolic acids, usually resulting from disturbances in the ability to excrete acid via the kidney

Kidney

The kidneys are Organ that have numerous biological roles. Their primary role is to maintain the homeostasis balance of bodily fluids by filtering and secreting Metabolomics#Metabolitess and minerals from the blood and excreting them, along with water , as urine....
s. Renal acidosis is associated with an accumulation of urea and creatinine as well as metabolic acid residues of protein catabolism.

An increase in the production of other acids may also produce metabolic acidosis. For example, lactic acidosis may occur from 1) severe (PaO₂ <36mm Hg) hypoxemia

Hypoxia (medical)

Hypoxia is a Pathology condition in which the body as a whole or a region of the body is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise....
causing a fall in the rate of oxygen diffusion from arterial blood to tissues, or 2) hypoperfusion (e.g. hypovolemic shock) causing an inadequate blood delivery of oxygen to tissues. A rise in lactate out of proportion to the level of pyruvate, e.g. in mixed venous blood, is termed "excess lactate", and may also be an indicator of fermention due to anaerobic metabolism occurring in muscle cells, as seen during strenuous exercise. Once oxygenation is restored, the acidosis clears quickly. Another example of increased production of acids occurs in starvation and diabetic acidosis. It is due to the accumulation of ketoacids (ketosis) and reflects a severe shift from glycolysis to lipolysis

Lipolysis

Lipolysis is the breakdown of fat stored in fat cells. During this process, free fatty acids are released into the bloodstream and circulate throughout the body....
for energy needs.

Acid consumption from poison

Poison

In the context of biology, poisons are Chemical substance that can cause disturbances to organisms, usually by chemical reaction or other activity on the molecular scale, when a sufficient quantity is absorbed by an organism....
ing, elevated levels of iron

Iron

Iron is a chemical element with the symbol Fe and atomic number 26. Iron is a Group 8 element and period 4 element. Iron is lustrous and silvery in color....
in the blood, and chronically decreased production of bicarbonate

Bicarbonate

In inorganic chemistry, bicarbonate is an intermediate form in the deprotonation of carbonic acid. Its chemical formula is HCO3−....
may also produce metabolic acidosis.

Metabolic acidosis is compensated for in the lungs, as increased exhalation of carbon dioxide promptly shifts the buffering equation to reduce metabolic acid. This is a result of stimulation to chemoreceptors

Chemosensor

A chemosensor, also known as chemoreceptor, is a sensory receptor that transduction a chemical signal into an action potential. Or, more generally, a chemosensor detects certain chemical stimuli in the environment....
which increases alveolar ventilation, leading to respiratory compensation, otherwise known as Kussmaul breathing

Kussmaul breathing

Kussmaul breathing is a deep and labored breathing pattern associated with severe metabolic acidosis, particularly diabetic ketoacidosis but also renal failure....
(a specific type of hyperventilation

Hyperventilation

In medicine, hyperventilation is the state of breathing faster and/or deeper than necessary, bringing about lightheadedness and other undesirable symptoms often associated with panic attacks....
). Should this situation persist the patient is at risk for exhaustion leading to respiratory failure

Respiratory failure

The term respiratory failure, in medicine, is used to describe inadequate gas exchange by the respiratory system, with the result that arterial oxygen and/or carbon dioxide levels cannot be maintained within their normal ranges....
.

Mutations to the V-ATPase

V-ATPase

Vacuolar type H+-ATPase is a highly conserved evolutionarily ancient enzyme with remarkably diverse functions in Eukaryote organisms. V-ATPases acidifiy a wide array of intracellular organelles and proton pump across the Cell membrane of numerous cell types....
'a4' or 'B1' isoforms result in distal renal tubular acidosis, a condition that leads to metabolic acidosis, in some cases with sensorineural deafness.

Arterial blood gas

Arterial blood gas

Anion gap

The anion gap is used to aid in the differential diagnosis of metabolic acidosis.Although the term "anion gap" usually implies "serum anion gap", the Urine anion gap is also a clinically useful measure....
can also differentiate between possible causes.

The Henderson-Hasselbalch equation

Henderson-Hasselbalch equation

In chemistry, the Henderson?Hasselbalch equation describes the derivation of pH as a measure of acidity in biological and chemical systems....
is useful for calculating blood pH, because blood is a buffer solution

Buffer solution

A buffer solution is an aqueous solution consisting of a mixture of a weak acid and its conjugate base or a weak base and its conjugate acid. It has the property that the pH of the solution changes very little when a small amount of acid or base is added to it....
. The amount of metabolic acid accumulating can also be quantitated by using buffer base deviation, a derivative estimate of the metabolic as opposed to the respiratory component. In hypovolemic shock for example, approximately 50% of the metabolic acid accumulation is lactic acid, which disappears as blood flow and oxygen debt are corrected.

Treatment of uncompensated metabolic acidosis is focused upon correcting the underlying problem. When metabolic acidosis is severe and can no longer be compensated for adequately by the lungs, neutralizing the acidosis with infusions of bicarbonate

Bicarbonate

In inorganic chemistry, bicarbonate is an intermediate form in the deprotonation of carbonic acid. Its chemical formula is HCO3−....
may be required.

Acidosis

Respiratory acidosis

Metabolic acidosis

See also

External links