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Gas Exchange in Acid‐Base Disturbances

Eugene E. Nattie

10.1002/cphy.cp030420

Source: Supplement 13: Handbook of Physiology, The Respiratory System, Gas Exchange

Originally published: 1987

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Definition of Gas Exchange
2 Acid‐Base Terminology
3 Effects of Acid‐Base Imbalance on Steps in O2 Delivery Process
3.1 Alveolar Ventilation
3.2 Pulmonary Vasculature
3.3 Airways
3.4 Pulmonary Gas Exchange
3.5 Hemoglobin
3.6 Cardiovascular System
3.7 Tissue Metabolism
4 Measured Net Effects of Acid‐Base Imbalance on O2 Delivery
4.1 Tissues
4.2 Whole Animal Stressed by Tissue Hypoxia
4.3 Whole Animal at Rest
4.4 Whole Animal in Exercise
5 Comparative Aspects of Acid‐Base Balance and Possible Relationship to O2 Delivery
5.1 Temperature and Acid‐Base Balance in Ectotherms
5.2 Significance for Gas Exchange in Homeotherms: Humans
6 Conclusions
Figure 1. Figure 1.

O2 concentration (Co2) shown as a function of partial pressure of O2 () in kPa for 2 values of arterial pH. Degree of venous admixture measured as the ratio of venous admixture to total blood flow (/) and O2 capacity (O2 capa) are shown. Only top portion of HbO2 dissociation curve is represented. For a given ideal end‐capillary‐to‐arterial O2 content difference (Cco2 ‐ Cao2), the ideal alveolar‐arterial difference in ( ‐ ) is greater in alkalosis than in acidosis.

From Frans et al. 47
Figure 2. Figure 2.

Plasma pH, erythrocyte 2,3‐diphosphoglycerate (2,3‐DPG), O2 half‐saturation pressure of Hb (P50) (7.4), and P50 (in vivo) in 4 human subjects during acidosis and alkalosis induced by agents noted at top. Each symbol represents a different subject.

From Bellingham et al. 8
Figure 3. Figure 3.

Cerebrospinal fluid (CSF) during acidosis and treatment with NaHCO3 in 9‐day‐old lambs. Plasma pH was decreased from 7.38 to 7.23 over 30 min via HCl infusion and gradually decreased to 7.11 at 8 h. NaHCO3 therapy increased plasma pH to 7.24 at 15 min and to 7.29 after 24 h.

From Berthiaume et al. 11
Figure 4. Figure 4.

Values of in vitro P50 (7.4 and 37°C) and in vivo P50 (pH and animal temperature) during acidosis and NaHCO3 therapy in 9‐day‐old lambs. (See Fig. 3 for details of plasma pH changes.) Open squares, expected P50 based only on the Bohr effect. Shaded areas, estimated effect of 2,3‐DPG decrease that counterbalances the expected P50 increase due only to the Bohr effect.

From Berthiaume et al. 11
Figure 5. Figure 5.

O2‐CO2 diagram, VS. . Line at right with points labeled A, lung respiratory exchange ratio (R) line of 0.7. Lines labeled I, III, and IV, blood R lines, each with R = 0.7. I: normal resting man. III: man with diabetic ketoacidosis. IV: nonacidotic man hyperventilating as in III. Points labeled A, alveolar points; points labeled a, arterial points. Numbers on blood R lines, fractions of normal blood flow assuming an arteriovenous O2 concentration difference of 4.6 ml O2/100 ml blood.

Data from Henderson 61
Figure 6. Figure 6.

O2‐CO2 diagram, VS. . Line at right, lung R line; open circles, arterial points; dashed lines, connect arterial points to lung R line at alveolar points. Open square, mean control rat subcutaneous gas pocket values. Solid circles, gas pocket values obtained in rats made acidotic by NH4Cl treatment.

From Van Liew 158
Figure 7. Figure 7.

Blood pH (pHB) and of toads (Bufo marinus), snapping turtles (Chelydra serpentina), and bullfrogs (Rana catesbeiana) shown as function of temperature. Curves are drawn from a binary buffer model solution for each animal. Open circles are in vivo data and closed circles are in vitro data from Howell et al. 64; open squares are data from Reeves 120.

From Reeves 123
Figure 8. Figure 8.

Values of pH vs. temperature in °C for 3 chemical solutions at constant CO2 content. A, pure carbonic acid‐bicarbonate solution; B, same as A plus 0.020 M imidazole; C, same as A plus 0.020 M phosphate. Lines, theoretical calculations based on model buffer systems.

From Reeves 120


Figure 1.

O2 concentration (Co2) shown as a function of partial pressure of O2 () in kPa for 2 values of arterial pH. Degree of venous admixture measured as the ratio of venous admixture to total blood flow (/) and O2 capacity (O2 capa) are shown. Only top portion of HbO2 dissociation curve is represented. For a given ideal end‐capillary‐to‐arterial O2 content difference (Cco2 ‐ Cao2), the ideal alveolar‐arterial difference in ( ‐ ) is greater in alkalosis than in acidosis.

From Frans et al. 47


Figure 2.

Plasma pH, erythrocyte 2,3‐diphosphoglycerate (2,3‐DPG), O2 half‐saturation pressure of Hb (P50) (7.4), and P50 (in vivo) in 4 human subjects during acidosis and alkalosis induced by agents noted at top. Each symbol represents a different subject.

From Bellingham et al. 8


Figure 3.

Cerebrospinal fluid (CSF) during acidosis and treatment with NaHCO3 in 9‐day‐old lambs. Plasma pH was decreased from 7.38 to 7.23 over 30 min via HCl infusion and gradually decreased to 7.11 at 8 h. NaHCO3 therapy increased plasma pH to 7.24 at 15 min and to 7.29 after 24 h.

From Berthiaume et al. 11


Figure 4.

Values of in vitro P50 (7.4 and 37°C) and in vivo P50 (pH and animal temperature) during acidosis and NaHCO3 therapy in 9‐day‐old lambs. (See Fig. 3 for details of plasma pH changes.) Open squares, expected P50 based only on the Bohr effect. Shaded areas, estimated effect of 2,3‐DPG decrease that counterbalances the expected P50 increase due only to the Bohr effect.

From Berthiaume et al. 11


Figure 5.

O2‐CO2 diagram, VS. . Line at right with points labeled A, lung respiratory exchange ratio (R) line of 0.7. Lines labeled I, III, and IV, blood R lines, each with R = 0.7. I: normal resting man. III: man with diabetic ketoacidosis. IV: nonacidotic man hyperventilating as in III. Points labeled A, alveolar points; points labeled a, arterial points. Numbers on blood R lines, fractions of normal blood flow assuming an arteriovenous O2 concentration difference of 4.6 ml O2/100 ml blood.

Data from Henderson 61


Figure 6.

O2‐CO2 diagram, VS. . Line at right, lung R line; open circles, arterial points; dashed lines, connect arterial points to lung R line at alveolar points. Open square, mean control rat subcutaneous gas pocket values. Solid circles, gas pocket values obtained in rats made acidotic by NH4Cl treatment.

From Van Liew 158


Figure 7.

Blood pH (pHB) and of toads (Bufo marinus), snapping turtles (Chelydra serpentina), and bullfrogs (Rana catesbeiana) shown as function of temperature. Curves are drawn from a binary buffer model solution for each animal. Open circles are in vivo data and closed circles are in vitro data from Howell et al. 64; open squares are data from Reeves 120.

From Reeves 123


Figure 8.

Values of pH vs. temperature in °C for 3 chemical solutions at constant CO2 content. A, pure carbonic acid‐bicarbonate solution; B, same as A plus 0.020 M imidazole; C, same as A plus 0.020 M phosphate. Lines, theoretical calculations based on model buffer systems.

From Reeves 120
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Article Title: Gas Exchange in Acid‐Base Disturbances
 

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Eugene E. Nattie. Gas Exchange in Acid‐Base Disturbances. Compr Physiol 2011, Supplement 13: Handbook of Physiology, The Respiratory System, Gas Exchange: 421-438. First published in print 1987. doi: 10.1002/cphy.cp030420