Acid-Base Physiology: A Direct Approach

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ISBN: 9780801863615 | 0801863619
Cover: Paperback
Copyright: 9/1/2000

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Supplemental Materials

Preface	p. xi
A Review of Fundamentals	p. xiii
From Buffers to Diagnosis
Buffer Systems	p. 1
Buffering That Relates to Change in pH	p. 3
Buffering That Relates to Change in the Concentration of Bicarbonate	p. 8
Buffer Distribution in Body Compartments and Buffering in Metabolic Acidosis	p. 10
Buffering in Metabolic Acidosis	p. 12
Relationships in Respiratory Disorders	p. 15
The Concept of Respiratory Acid	p. 15
Control of Concentration of Dissolved CO[subscript 2]	p. 15
Buffering in Respiratory Acidosis	p. 16
Acute Buffering Reaction to Carbonic Acid	p. 17
A Paradox--Tissue Buffering in Metabolic Acidosis	p. 20
CO[subscript 2]-Carbonic Acid System: Role of Lung and Kidney	p. 20
Henderson-Hasselbalch Equation	p. 20
Open and Closed Systems	p. 22
The Four Primary Events and the Four Compensatory Responses	p. 25
Diagnosis	p. 27
Recommended Approach	p. 29
Role of pH	p. 30
References	p. 32
Renal Excretion of Acid and Reabsorption of Bicarbonate
The Problem and the Pathway	p. 33
Transport and Excretion of Acid Products of Cellular Metabolism	p. 34
Weak and Strong Acids	p. 34
Excretion of Weak and Strong Acids, Na-H Exchanges and Secretion of Hydrogen Ions	p. 37
Excretion of Weak Acids	p. 37
Excretion of Strong Acids and Formation of Ammonia	p. 39
The Primary Event and Regulation of Extracellular Concentrations	p. 41
Bicarbonate and the Kidney: Recovery, Reabsorption, and Regulation	p. 42
Increased Pco[subscript 2] as Cause for Increased Addition of Bicarbonate to Extracellular Fluid	p. 44
Terminology and Rates	p. 46
Clinical Correlations	p. 46
Compensation in Respiratory Acidosis	p. 46
Diagnostic Evaluation of "Mixed" Acid-Base Disease	p. 47
Excretion of Excess Alkali	p. 49
Accumulation of Organic Acids and the "Anion Gap"	p. 51
Titratable Acid	p. 51
Disorders of Bicarbonate Reabsorption	p. 52
Acidosis and Chronic Renal Failure	p. 53
References	p. 53
Quantitative Approaches in Diagnosis and Therapy
Sodium and Chloride and Regulation of the Acidity of the Extracellular Fluid	p. 55
Volumes and Concentrations	p. 58
Measurement of the Volume of Extracellular Fluid	p. 59
Osmotic Effects and Intra/Extracellular Shifts of Water	p. 61
Replacement Therapy	p. 64
Essential Components: H[superscript +] and OH[superscript -], or Na[superscript +] and Cl[superscript -]	p. 64
Management of Therapy	p. 65
References	p. 69
The Mechanism of Tissue Buffering in Metabolic Acidosis
Quantitative Relationships	p. 71
The Primary Problem	p. 73
Homeostasis and Intracellular CO[subscript 2]-Carbonic Acid Reactions	p. 74
Tentative Valuation of Intracellular Changes	p. 76
Possible Mechanisms in Muscle	p. 78
Bone as a Source of Buffering	p. 79
References	p. 80
Model Experiments
Methods and Assumptions	p. 81
Plasma and Interstitial Fluids as a Single Functional Compartment in Acid-Base Physiology	p. 82
Metabolic Acidosis	p. 82
Metabolic Alkalosis	p. 84
Respiratory Alkalosis and Acidosis	p. 86
Unknowns	p. 87
Answers to the Exercises in Experiment 4	p. 88
Clinical Relevance of the Experiments	p. 91
Concentrations versus Quantities	p. 91
Arithmetic and Therapy	p. 91
References	p. 93
Case Histories
Problems in Acid-Base Physiology as Seen in the Hospital	p. 94
Metabolic Alkalosis due to Loss of Gastric Contents	p. 94
Respiratory Acidosis	p. 96
Respiratory Alkalosis due to Hyperventilation	p. 96
Metabolic Acidosis Resulting from Diarrhea and Associated with Hypertonicity	p. 97
Metabolic Alkalosis Induced by Diuretic Therapy	p. 101
Metabolic Acidosis Complicating Diabetes	p. 102
Pathophysiology and Treatment of Diabetic Acidosis	p. 103
Potassium Deficiency and Potassium Therapy	p. 106
Causes of Potassium Deficiency	p. 106
Symptoms and Signs	p. 107
Therapy	p. 107
References	p. 107
Appendix
Estimation and Evaluation of Plasma Bicarbonate	p. 109
The Van Slyke Gasometric analysis	p. 109
Automated Analysis and Collection of Blood	p. 109
The Astrup and Siggaard-Andersen Method	p. 110
"Standard Bicarbonate," "Base Excess," and "Buffer Base"	p. 110
An Alternative Approach: pH versus nmoles/liter	p. 113
Nomogram for Application of the Henderson-Hasselbalch Equation	p. 114
References	p. 116
Exercises for the Student
Questions Concerned with Diagnosis	p. 117
CO[subscript 2] Questions	p. 119
Questions for Discussion	p. 119
Answers to the Questions	p. 120
Index	p. 125
Table of Contents provided by Syndetics. All Rights Reserved.

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