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Abstract
Acid-base balance is a complex physiological process that maintains a stable extracellular pH in the body. This balance is regulated by intracellular and extracellular buffers, as well as the respiratory and renal systems. The bicarbonate buffer system plays a fundamental role in this regulation. This article aims to review the normal physiological mechanisms involved in acid-base balance, the function of major buffer systems, and the contributions of the respiratory and urinary systems. Understanding these physiological processes is essential for managing and treating disorders caused by disruptions in acid-base homeostasis. This study is conducted as a review, and findings highlight those buffers and the respiratory system help minimize pH fluctuations, while full compensation occurs through renal adjustments.
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References
- Atherton, J. C. (2009). Acid–base balance: maintenance of plasma pH. Anaesthesia & Intensive Care Medicine, 10(11), 557-561. https://doi.org/10.1016/j.mpaic.2009.08.005
- Bittar, E. E. (2002). Pulmonary biology in health and disease. Springer Science & Business Media. Springer Science & Business Media. https://doi.org/10.1007/0-387-21657-x_11
- Bobulescu, I. A., & Moe, O. W. (2006). Na+/H+ exchangers in renal regulation of acid-base balance. In Seminars in nephrology (Vol. 26, No. 5, pp. 334-344). WB Saunders. https://doi.org/10.1016/j.semnephrol.2006.07.001
- Das, B. (2003). Acid-base disorders. Indian Journal of Anaesthesia. 2003 Sep 1;47(5):373-9. https://doi.org/10.1007/978-0-387-21744-4_96
- Ferguson, J. K. W., & Roughton, F. J. W. (1934). The chemical relationships and physiological importance of carbamino compounds of CO2 with haemoglobin. The Journal of Physiology, 83(1),87. https://doi.org/10.1113/jphysiol.1934.sp003213
- Foster, G,T., Vaziri, N.D., Sassoon, C.S. (2001). Respiratory alkalosis. Respiratory care. 1;46(4):384-91. https://doi.org/10.1201/9781315140629-19
- Garbacz, G., Kołodziej, B., Koziolek, M., Weitschies, W., & Klein, S. (2013). An automated system for monitoring and regulating the pH of bicarbonate buffers. Aaps Pharmscitech, 14, 517-522. https://doi.org/10.1208/s12249-013-9933-5
- Goel, N., & Calvert, J. (2012). Understanding blood gases/acid–base balance. Paediatrics and Child Health, 22(4), 142-148. https://doi.org/10.1016/j.paed.2011.09.005
- Greenbaum, J., & Nirmalan, M. (2005). Acid–base balance: The traditional approach. Current Anaesthesia & Critical Care, 16(3), 137-142. https://doi.org/10.1016/j.cacc.2005.03.009
- Hamm, L. L., Nakhoul, N., & Hering-Smith, K. S. (2015). Acid-base homeostasis. Clinical journal of the American Society of Nephrology, 10(12),2232-2242. https://doi.org/10.2215/cjn.07400715
- Hopkins, E., Sanvictores, T., & Sharma, S. (2018). Physiology, acid base balance. In: StatPearls. StatPearls Publishing Treasure Island (FL); PMID: 29939584.
- Kane, K. K. (1973). The role of the lungs in the adjustment of acid-base balance. Annals of Clinical & Laboratory Science, 3(5),323-328. https://doi.org/10.3109/00365517309084338
- Klein, T. B. G. (2012). Cunningham's Textbook of Veterinary Physiology-E-Book: Cunningham's Textbook of Veterinary Physiology-E-Book. Elsevier Health Sciences. ISBN: 978-1-4377-2361-8
- Koeppen, B. M. (1998). Renal regulation of acid-base balance. Advances in physiology education, 275(6), S132-141. https://doi.org/10.1152/advances.1998.275.6.s132
- Krajewska, B., & Zaborska, W. (1999). The effect of phosphate buffer in the range of pH 5.80–8.07 on jack bean urease activity. Journal of Molecular Catalysis B: Enzymatic, 6(1-2), 75-81. https://doi.org/10.1016/s1381-1177(98)00129-5
- McNamara, J., & Worthley, L. I. G. (2001). Acid-base balance: part I. Physiology. Critical Care and Resuscitation, 3(3), 181-187. https://doi.org/10.1016/s1441-2772(23)00613-0
- Mithoefer, J. C., Thibeault, D. W., & Bossman, O. G. (1969). Acid-base balance and the effect of oxyhemoglobin reduction on CO2 transport. Respiration Physiology, 6(3), 292-297. https://doi.org/10.1016/0034-5687(69)90028-0
- Muir, W.W. (2015). Acid–base physiology. Veterinary Anesthesia and Analgesia: The Fifth Edition of Lumb and Jones. 29:355-71. https://doi.org/10.1002/9781119421375.ch18
- Nakamura, M., Shirai, A., Yamazaki, O., Satoh, N., Suzuki, M., Horita, S., ... & Seki, G. (2014). Roles of renal proximal tubule transport in acid/base balance and blood pressure regulation. BioMed research international, 2014(1), 504808. https://doi.org/10.1155/2014/504808
- Nikinmaa, M., Airaksinen, S., & Virkki, L. V. (1995). Haemoglobin function in intact lamprey erythrocytes: interactions with membrane function in the regulation of gas transport and acid–base balance. Journal of experimental biology, 198(12), 2423-2430. https://doi.org/10.1242/jeb.198.12.2423
- Peters, R. M., & Hedgpeth Jr, E. M. (1966). Acid-base balance and respiratory work. The Journal of Thoracic and Cardiovascular Surgery, 52(5),649-654.https://doi.org/10.1016/s0022-5223(19)43374-6
- Pitts, R. F., & Lotspeich, W. D. (1946). Bicarbonate and the renal regulation of acid base balance. American Journal of Physiology-Legacy Content, 147(1), 138-154. https://doi.org/10.1152/ajplegacy.1946.147.1.138
- Reece, W. O., Erickson, H. H., Goff, J. P., & Uemura, E. E. (13 ed). (2015). Dukes' physiology of domestic animals. John Wiley & Sons. ISBN 978-1-118-50139-9
- Shaw, I., & Gregory, K. (2022). Acid–base balance: a review of normal physiology. BJA education, 22(10), 396-401. https://doi.org/10.1016/j.bjae.2022.06.003
- Tinawi, M. (2021). Respiratory acid-base disorders: respiratory acidosis and respiratory alkalosis. Archives of Clinical and Biomedical Research;5(2):158-68. https://doi.org/10.26502/acbr.50170157
- Vasuvattakul, S., Warner, L. C., & Halperin, M. L. (1992). Quantitative role of the intracellular bicarbonate buffer system in response to an acute acid load. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 262(2), R305-R309. https://doi.org/10.1152/ajpregu.1992.262.2.r305
References
Atherton, J. C. (2009). Acid–base balance: maintenance of plasma pH. Anaesthesia & Intensive Care Medicine, 10(11), 557-561. https://doi.org/10.1016/j.mpaic.2009.08.005
Bittar, E. E. (2002). Pulmonary biology in health and disease. Springer Science & Business Media. Springer Science & Business Media. https://doi.org/10.1007/0-387-21657-x_11
Bobulescu, I. A., & Moe, O. W. (2006). Na+/H+ exchangers in renal regulation of acid-base balance. In Seminars in nephrology (Vol. 26, No. 5, pp. 334-344). WB Saunders. https://doi.org/10.1016/j.semnephrol.2006.07.001
Das, B. (2003). Acid-base disorders. Indian Journal of Anaesthesia. 2003 Sep 1;47(5):373-9. https://doi.org/10.1007/978-0-387-21744-4_96
Ferguson, J. K. W., & Roughton, F. J. W. (1934). The chemical relationships and physiological importance of carbamino compounds of CO2 with haemoglobin. The Journal of Physiology, 83(1),87. https://doi.org/10.1113/jphysiol.1934.sp003213
Foster, G,T., Vaziri, N.D., Sassoon, C.S. (2001). Respiratory alkalosis. Respiratory care. 1;46(4):384-91. https://doi.org/10.1201/9781315140629-19
Garbacz, G., Kołodziej, B., Koziolek, M., Weitschies, W., & Klein, S. (2013). An automated system for monitoring and regulating the pH of bicarbonate buffers. Aaps Pharmscitech, 14, 517-522. https://doi.org/10.1208/s12249-013-9933-5
Goel, N., & Calvert, J. (2012). Understanding blood gases/acid–base balance. Paediatrics and Child Health, 22(4), 142-148. https://doi.org/10.1016/j.paed.2011.09.005
Greenbaum, J., & Nirmalan, M. (2005). Acid–base balance: The traditional approach. Current Anaesthesia & Critical Care, 16(3), 137-142. https://doi.org/10.1016/j.cacc.2005.03.009
Hamm, L. L., Nakhoul, N., & Hering-Smith, K. S. (2015). Acid-base homeostasis. Clinical journal of the American Society of Nephrology, 10(12),2232-2242. https://doi.org/10.2215/cjn.07400715
Hopkins, E., Sanvictores, T., & Sharma, S. (2018). Physiology, acid base balance. In: StatPearls. StatPearls Publishing Treasure Island (FL); PMID: 29939584.
Kane, K. K. (1973). The role of the lungs in the adjustment of acid-base balance. Annals of Clinical & Laboratory Science, 3(5),323-328. https://doi.org/10.3109/00365517309084338
Klein, T. B. G. (2012). Cunningham's Textbook of Veterinary Physiology-E-Book: Cunningham's Textbook of Veterinary Physiology-E-Book. Elsevier Health Sciences. ISBN: 978-1-4377-2361-8
Koeppen, B. M. (1998). Renal regulation of acid-base balance. Advances in physiology education, 275(6), S132-141. https://doi.org/10.1152/advances.1998.275.6.s132
Krajewska, B., & Zaborska, W. (1999). The effect of phosphate buffer in the range of pH 5.80–8.07 on jack bean urease activity. Journal of Molecular Catalysis B: Enzymatic, 6(1-2), 75-81. https://doi.org/10.1016/s1381-1177(98)00129-5
McNamara, J., & Worthley, L. I. G. (2001). Acid-base balance: part I. Physiology. Critical Care and Resuscitation, 3(3), 181-187. https://doi.org/10.1016/s1441-2772(23)00613-0
Mithoefer, J. C., Thibeault, D. W., & Bossman, O. G. (1969). Acid-base balance and the effect of oxyhemoglobin reduction on CO2 transport. Respiration Physiology, 6(3), 292-297. https://doi.org/10.1016/0034-5687(69)90028-0
Muir, W.W. (2015). Acid–base physiology. Veterinary Anesthesia and Analgesia: The Fifth Edition of Lumb and Jones. 29:355-71. https://doi.org/10.1002/9781119421375.ch18
Nakamura, M., Shirai, A., Yamazaki, O., Satoh, N., Suzuki, M., Horita, S., ... & Seki, G. (2014). Roles of renal proximal tubule transport in acid/base balance and blood pressure regulation. BioMed research international, 2014(1), 504808. https://doi.org/10.1155/2014/504808
Nikinmaa, M., Airaksinen, S., & Virkki, L. V. (1995). Haemoglobin function in intact lamprey erythrocytes: interactions with membrane function in the regulation of gas transport and acid–base balance. Journal of experimental biology, 198(12), 2423-2430. https://doi.org/10.1242/jeb.198.12.2423
Peters, R. M., & Hedgpeth Jr, E. M. (1966). Acid-base balance and respiratory work. The Journal of Thoracic and Cardiovascular Surgery, 52(5),649-654.https://doi.org/10.1016/s0022-5223(19)43374-6
Pitts, R. F., & Lotspeich, W. D. (1946). Bicarbonate and the renal regulation of acid base balance. American Journal of Physiology-Legacy Content, 147(1), 138-154. https://doi.org/10.1152/ajplegacy.1946.147.1.138
Reece, W. O., Erickson, H. H., Goff, J. P., & Uemura, E. E. (13 ed). (2015). Dukes' physiology of domestic animals. John Wiley & Sons. ISBN 978-1-118-50139-9
Shaw, I., & Gregory, K. (2022). Acid–base balance: a review of normal physiology. BJA education, 22(10), 396-401. https://doi.org/10.1016/j.bjae.2022.06.003
Tinawi, M. (2021). Respiratory acid-base disorders: respiratory acidosis and respiratory alkalosis. Archives of Clinical and Biomedical Research;5(2):158-68. https://doi.org/10.26502/acbr.50170157
Vasuvattakul, S., Warner, L. C., & Halperin, M. L. (1992). Quantitative role of the intracellular bicarbonate buffer system in response to an acute acid load. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 262(2), R305-R309. https://doi.org/10.1152/ajpregu.1992.262.2.r305