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Acid–Base Physiology

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Abstract

Normal human physiology demands and maintains systemic pH in a very narrow range due to intracellular and extracellular mechanisms that correct for physiologic and pathologic perturbations. The most common mechanism for compensation of pH abnormalities is through the respiratory and renal systems, which control carbon dioxide (CO2) and bicarbonate (HCO3 −) homeostasis. Carbon dioxide, a volatile acid, is a by-product of cellular aerobic respiration that combines with water to form carbonic acid (H2CO3) which can be catalyzed by carbonic anhydrase to produce protons (H+) and bicarbonate (HCO3 −).

Nonvolatile organic acids can be produced from biomolecular catabolism, as seen with sulfuric and phosphoric acids (H2SO4 and H3PO4). Lactate, a by-product of anaerobic respiration, and keto acid, a by-product of starvation states, are other endogenous sources of acids. Buffer solutions, weak acids or bases and their conjugate bases and acids, are the first line of defense against significant changes in the pH. These can be found in extracellular and intracellular compartments. The most common extracellular buffers include those of the bicarbonate and carbon dioxide systems described above. Other buffering systems, such as phosphates and proteins, have a relatively minor effect on maintenance of physiologic pH.

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Authors and Affiliations

  1. Department of Surgery, Duke University Medical Center, Durham, NC, USA

    Christopher R. Reed & Suresh “ Mitu” Agarwal

  2. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Amy Liepert

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  1. Christopher R. Reed
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  2. Amy Liepert
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Correspondence to Suresh “ Mitu” Agarwal .

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  1. Department of Surgery, Yale University School of Medicine, New Haven, CT, USA

    Kimberly A. Davis

  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA

    Stanley H. Rosenbaum

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Reed, C.R., Liepert, A., Agarwal, S.“.M. (2020). Acid–Base Physiology. In: Davis, K., Rosenbaum, S. (eds) Surgical Metabolism. Springer, Cham. https://doi.org/10.1007/978-3-030-39781-4_3

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